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99469 Neonate critical care subsq

Evaluation & Management

Also known as: neonatal critical care daily, NICU daily care

Subsequent critical care evaluation and management of neonate (birth to 28 days) per calendar day requiring intensive care unit level services.

In Plain Language

ongoing intensive hospital care for newborn each day

Clinical Context

Used for daily critical care management of hospitalized neonates in intensive care unit, including ongoing assessment, monitoring, and therapeutic interventions.

RVU Breakdown

Work RVU7.99
Total RVU7.99

Est. Medicare Payment

$266.87

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 7.99, this code ranks in the 98th percentile among Evaluation & Management codes — 5.2x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

NeonatologyCritical Care

Frequently Asked Questions

What is CPT code 99469?

CPT 99469 (Neonate critical care subsq) is a Evaluation & Management code. Subsequent critical care evaluation and management of neonate (birth to 28 days) per calendar day requiring intensive care unit level services.

Who uses CPT code 99469?

CPT 99469 is used by Neonatology, Critical Care. Used for daily critical care management of hospitalized neonates in intensive care unit, including ongoing assessment, monitoring, and therapeutic interventions.

When is CPT 99469 used?

Used for daily critical care management of hospitalized neonates in intensive care unit, including ongoing assessment, monitoring, and 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.