Critical Care (99291-99292)
CPT codes for evaluation and management of a critically ill or critically injured patient, time-based.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Billing
- Primary sources
- 1
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Where this comes up
This shows up in revenue-cycle work — claim scrubbing, charge entry, posting, A/R follow-up, and month-end close. Billers and practice managers hit this term when reconciling a payment, working a denial queue, or auditing why a claim aged past 60 days.
Full definition
What it is in practice
99291 covers the first 30-74 minutes of critical care on a calendar date; 99292 covers each additional 30 minutes. Critical care requires high-complexity decision making and an unstable patient.
How it shows up in your practice
Time must be documented. Time spent on procedures with separate codes (intubation, central line) cannot be counted toward critical care time.
Sources
- CMS — E/M Services Guidehttps://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf
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D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
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This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.