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99471 Pediatric critical care initial

Evaluation & Management

Also known as: pediatric critical care, PICU admission, pediatric ICU

Initial critical care evaluation and management of acutely ill or injured child (pediatric patient age 2 years and older) requiring intensive care.

In Plain Language

intensive hospital care for very sick children

Clinical Context

Used for initial comprehensive critical care of children age 2 and older with serious conditions requiring high-acuity monitoring and interventions.

RVU Breakdown

Work RVU15.98
Total RVU15.98

Est. Medicare Payment

$533.73

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 15.98, this code ranks in the 99th percentile among Evaluation & Management codes — 10.3x the median (1.54). The highest wRVU in this category is 18.46.

Specialties

PediatricsCritical Care

Frequently Asked Questions

What is CPT code 99471?

CPT 99471 (Pediatric critical care initial) is a Evaluation & Management code. Initial critical care evaluation and management of acutely ill or injured child (pediatric patient age 2 years and older) requiring intensive care.

Who uses CPT code 99471?

CPT 99471 is used by Pediatrics, Critical Care. Used for initial comprehensive critical care of children age 2 and older with serious conditions requiring high-acuity monitoring and interventions.

When is CPT 99471 used?

Used for initial comprehensive critical care of children age 2 and older with serious conditions requiring high-acuity monitoring and 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.