Billing code 99466: Critical care transportMedicare rate & RVUs in Washington
Reports a clinician’s face-to-face critical care during transport of a critically ill or injured child age 24 months or younger.
CMS doesn’t publish an office rate for 99466 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 99466 covers
99466 covers face-to-face critical care provided by a physician or other qualified health care professional while a critically ill or injured child age 24 months or younger is being transported. A typical situation is an interfacility transfer for a child who needs ongoing intensive monitoring or treatment en route to a higher level of pediatric or neonatal care. The service is the clinician’s care during transport, not the ambulance trip itself.
Report 99466 for the first 30–74 minutes of clinical care during transport. For additional qualifying time, report 99467, the add-on code for each additional 30 minutes. Documentation should establish the child’s age and critical condition, the transport, the clinician’s face-to-face care, and the time spent providing it. The Medicare Physician Fee Schedule assigns work, practice-expense, and malpractice RVUs to this service; the applicable payment amount is displayed separately.
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.
Where 99466 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $203.30 |
| Seattle (King Cnty) | Unavailable | $215.38 |
How the 99466 rate is calculated
Each of 99466’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 99466
RVUs × geographic indexes × conversion factor
Work4.79
4.79 RVUs× 1.000 GPCI
Practice expense0.97
0.97 RVUs× 1.000 GPCI
Malpractice0.28
0.28 RVUs× 1.000 GPCI
Adjusted RVUs
6.0400
Conversion factor
$33.4009
Medicare rate
$201.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99466
99466 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 99466
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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99466 isn’t priced in this setting.
99466 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99467Critical care transport
- 99467 covers each additional 30 minutes after the initial 99466 interval; it is not used for the first transport interval.
- 99468Neonatal critical care
- 99468 reports initial critical care for a neonate, rather than the clinician’s face-to-face critical care during transport.
- 99471Pediatric critical care
- 99471 reports initial pediatric critical care outside the transport service; 99466 is specific to face-to-face care during transport for a child age 24 months or younger.
99466 billing questions
When should 99466 be chosen over 99467?
99466 reports the first 30–74 minutes of face-to-face critical care during transport. Report 99467 for each additional 30 minutes.
Does 99466 include the ambulance charge?
No. It reports the clinician’s critical care during transport, not the vehicle or ambulance transportation service.
What time should the record support?
Document the time spent providing face-to-face clinical care during transport, along with the child’s critical condition and care provided en route.
Can 99466 be reported with critical care at the destination?
The transport service describes care during the trip; critical care furnished separately at the destination is a different service. Document the distinct care and its own time.
Does the patient’s age affect code selection?
Yes. 99466 is for transport critical care involving a child age 24 months or younger. The record should support the patient’s age.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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