CPT 99291, CPT 99292, CPT code 99291, CPT code 99292, 99291 CPT code, 99292 CPT code, 99291 CPT, 99292 CPT

CPT 99291 & CPT 99292 (Critical Care Services)

CPT 99291 may be used for a critical care service provided for a minimum of 30 and a maximum of 74 minutes. CC services that are provided for less than 30 minutes must be billed with the correct level of Evaluation and Management code.

TIP: You can find the complete billing guide for CPT code 99291 here.

Critical care services include:

  • prevention of further life–threatening conditions
  • the treatment of vital organ failure.

The following three criteria must be met for reporting CC service:  

  1. An absolute requirement is the proper documentation showing the medical necessity for providing CC services.
  2. The time spent in providing the care.
  3. The severity of illness the intensity of services required to treat the illness.

Most of the times a critical care service is provided to a patient in a “critical care area” such as:

  • An emergency room
  • intensive care unit (ICU)
  • Respiratory care unit
  • Coronary care unit (CCU)

Note: Delivering medical care in time of emergency and/or a moment of crisis and is not the only requirement for providing CC services. The use of ventilation nor presence of a patient in an ICU the is not sufficient to bill a CC service.

CPT 99292 Description: CPT 99292 is an add-on code. This is an “add–on” code from CPT 99291 and can only be used with the primary CPT code 99291. CPT 99292 can be used for a critical care service provided for every extra 30 minutes of service after the first 30–74 minutes (see CPT 99291) of direct critical care treatment provided.

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