CPTCodeCalculator
E/MBase2026 Compliant

CPT 99284

2026 Billing Guide

ED Visit, High

Reimbursement

$117.57

Threshold

N/A

2026 Status

Active

What is CPT Code 99284?

CPT 99284 is defined as: Emergency department visit for the evaluation and management of a patient, which requires a medically appropriate history and/or examination and high level medical decision making. Typically involves severe symptoms or high risk of morbidity, but no immediate threat to life.

This code is primarily used for E/M services. It falls under the category of Hospital Inpatient/Observation & Emergency Department and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

2.74

Physician Effort

PE (Non-Fac)

0.56

Practice Expense

Malpractice

0.22

Risk Factor

Total RVU

3.52

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

complexity incentive

wRVU of 2.74 recognizes the high diagnostic and management intensity required for serious ED presentations.

efficiency shield

Exempt from -2.5% efficiency cut.

facility tiering

Often corresponds to Level 4 or 5 hospital facility charges.

Administrative Framework

Global Period

000

Place of Service

23 (Emergency Room - Hospital)

NCCI Exclusions

Do not bill with:99281-9928399285

Operational Requirements

minimum time

Not time-based

staff type

Physician or other Qualified Health Care Professional (QHP)

frequency

Per encounter

add on codes

care plan requirement

High medical decision making involving complex differential diagnosis and management of severe symptoms.

Compliance Checklist

High MDM documentation (complex data review, high risk of morbidity)
Summary of extensive diagnostic testing and results
Evidence of complex clinical thinking or multiple specialty considerations
Detailed disposition plan and risks explained to the patient

Audit Defense

No specific audit defense elements defined.

2026 Update

High-risk social determinants of health (SDOH) can now contribute to the 'risk' element of MDM for 99284 – ensure SDOH factor is documented.

Common Clinical Scenarios

Evaluation of severe shortness of breath in a patient with history of heart failure
Severe abdominal pain with signs of dehydration and complex history

CMS Eligibility: 1+ acute illness with high risk of morbidity or 1 acute worsening of severe chronic illness. Acute

Target Specialties & Utilization

Emergency Medicine

Typical Clinical Indications (ICD-10)

R06.02 (Shortness of breath)I50.31 (Acute diastolic left heart failure)N20.0 (Calculus of kidney)

Billing Differentiation

VS 99283

99283 is moderate; 99284 is high MDM.

VS 99285

99285 involves 'immediate' threat to life or function.

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CPT Code 99284 for ED Visit, High - 2026 Reimbursement & Rules