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99291 Critical care first hour

Evaluation & Management

Also known as: critical care, ICU care, critical illness, critical care first hour, ICU care first hour, intensive care unit, critical care time

Evaluation and management of the critically ill or critically injured patient; first 30 to 74 minutes of physician or qualified health professional time spent directly at bedside and on the patient's hospital care.

In Plain Language

Intensive care treatment; Critical emergency care

Clinical Context

Used for critically ill or critically injured patients requiring comprehensive evaluation and management in intensive care settings, including continuous physiological monitoring and complex therapeutic interventions.

RVU Breakdown

Work RVU4.50
Total RVU4.50

Est. Medicare Payment

$150.30

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 4.50, this code ranks in the 94th percentile among Evaluation & Management codes — 2.9x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

Critical CareHospital MedicineEmergency Medicine

Frequently Asked Questions

What is CPT code 99291?

CPT 99291 (Critical care first hour) is a Evaluation & Management code. Evaluation and management of the critically ill or critically injured patient; first 30 to 74 minutes of physician or qualified health professional time spent directly at bedside and on the patient's hospital care.

Who uses CPT code 99291?

CPT 99291 is used by Critical Care, Hospital Medicine, Emergency Medicine. Used for critically ill or critically injured patients requiring comprehensive evaluation and management in intensive care settings, including continuous physiological monitoring and complex therapeutic interventions.

When is CPT 99291 used?

Used for critically ill or critically injured patients requiring comprehensive evaluation and management in intensive care settings, including continuous physiological monitoring and complex therapeutic interventions.

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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.