$30.16
Both describe established-patient online E/M over seven days. Choose 99421 for 5–10 cumulative minutes and 99422 for 11–20 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
99421 Online E/M Medicare reimbursement rates in Minnesota
Report 99421 for an established patient’s online, asynchronous evaluation and management when the clinician’s cumulative work totals 5–10 minutes over seven days. Compare 99421 office and facility rates across CMS payment localities in Minnesota.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 99421 in Minnesota?
Minnesota has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$15.42
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
Facility setting
$10.61
1 of 1 localities have a supported rate.
Payment area: Minnesota
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Digital evaluation and management
About 99421: Established Patient Online Digital Evaluation
Report 99421 for an established patient’s online, asynchronous evaluation and management when the clinician’s cumulative work totals 5–10 minutes over seven days.
99421 covers a patient-initiated online evaluation and management service for an established patient. A physician or other qualified health care professional may review the patient’s secure portal message, assess the concern, review relevant records, make a management plan, and communicate recommendations or orders electronically. The service is asynchronous; it is not a scheduled video or telephone visit.
Select this level when the clinician’s cumulative time on the online evaluation and management work is 5–10 minutes during the seven-day period. Count the work across the episode rather than reporting separately for each message. Documentation should show the patient’s concern, the clinician’s assessment and management, the communication, and the total time. When the same problem leads to an in-person or other E/M service during the applicable period, the online work is generally included in that E/M service rather than reported separately.
Where the value comes from
- Work RVU0.25 · 53%
- Practice expense (office) RVU0.20 · 43%
- Malpractice RVU0.02 · 4%
89.2K
Medicare services in 2024 · #594 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
99421 compared with similar codes
Office rates for Minnesota, from the same CMS release.
$48.18
Both describe established-patient online E/M over seven days. Choose 99421 for 5–10 cumulative minutes and 99423 for 21 minutes or more.
Compare 99421 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Minnesota →
Office / nonfacility
$15.42
Facility
$10.61
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99421 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
13,102
- Code
- 99421
- Physician work
- 0.25
- Practice expense
- 0.20
- Malpractice
- 0.02
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.25 | × 1.000 | 0.2500 |
| Practice expense | 0.20 | × 1.029 | 0.2058 |
| Malpractice | 0.02 | × 0.296 | 0.0059 |
| Total RVUs | 0.4617 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Minnesota$15.42
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.25 | 1 |
| Practice expense | 0.2 | 1.029 |
| Malpractice | 0.02 | 0.296 |
(0.25 × 1 + 0.2 × 1.029 + 0.02 × 0.296) × $33.4009 = $15.42
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.25 | 1 |
| Practice expense | 0.06 | 1.029 |
| Malpractice | 0.02 | 0.296 |
(0.25 × 1 + 0.06 × 1.029 + 0.02 × 0.296) × $33.4009 = $10.61
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
99421 billing questions
When should 99421 be chosen over 99422 or 99423?
Use 99421 when cumulative online E/M time is 5–10 minutes over seven days. The higher-level codes are for longer time: 11–20 minutes for 99422 and 21 minutes or more for 99423.
Can each portal message be reported as a separate unit?
No. Combine the clinician’s time for the online E/M work over the seven-day period and report the applicable level once for that episode.
What documentation supports 99421?
Document the established patient’s online concern, the clinician’s evaluation and management, the response or plan, and cumulative time for the seven-day period.
Does 99421 describe a video visit?
No. It describes asynchronous online E/M work, such as review and response through a secure patient portal; it is not a synchronous video encounter.
How does 99421 differ from G2012?
99421 captures a broader online evaluation and management episode with cumulative work over seven days. G2012 describes a brief communication technology-based check-in.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
13,09999416,,Prolng clin staff svc ea add,A,,0.00,0.37,,0.37,NA,0.01,0.38,0.38,3,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10099417,,Prolng op e/m each 15 min,I,+,0.61,0.31,,0.14,,0.04,0.96,0.79,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10199418,,Prolng ip/obs e/m ea 15 min,I,+,0.81,0.18,NA,0.18,,0.05,1.04,1.04,9,ZZZ,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10299421,,Ol dig e/m svc 5-10 min,A,,0.25,0.20,,0.06,,0.02,0.47,0.33,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10399422,,Ol dig e/m svc 11-20 min,A,,0.50,0.38,,0.13,,0.04,0.92,0.67,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10499423,,Ol dig e/m svc 21+ min,A,,0.80,0.61,,0.20,,0.05,1.46,1.05,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,10599424,,Prin care mgmt phys 1st 30,A,,1.45,1.06,,0.38,,0.11,2.62,1.94,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002