99211 Off/outpatient established may x req phy/qhp
Also known as: nurse visit, established visit minimal, may not require physician, established patient office visit level 1, minimal visit
Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or qualified health professional. This visit involves minimal medical decision-making.
In Plain Language
Brief visit with office staff; Nursing appointment
Clinical Context
Used for brief established patient office visits that can be conducted by nursing or clinical staff, such as vital signs monitoring, medication refills, or simple follow-up questions.
RVU Breakdown
| Work RVU | 0.18 |
| Total RVU | 0.18 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.
How This Code Compares
With a work RVU of 0.18, this code ranks in the 2nd percentile among Evaluation & Management codes — 8.6x below the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99211?
CPT 99211 (Off/outpatient established may x req phy/qhp) is a Evaluation & Management code. Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician or qualified health professional. This visit involves minimal medical decision-making.
Who uses CPT code 99211?
CPT 99211 is used by Primary Care, Family Medicine, Internal Medicine. Used for brief established patient office visits that can be conducted by nursing or clinical staff, such as vital signs monitoring, medication refills, or simple follow-up questions.
When is CPT 99211 used?
Used for brief established patient office visits that can be conducted by nursing or clinical staff, such as vital signs monitoring, medication refills, or simple follow-up questions.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.