CPT 99471
Ped critical care initial
CPT 99471 at a glance
- Code
- 99471
- Code type
- CPT/HCPCS (Add. EE)
- Short descriptor
- Ped critical care initial
- Category
- Excluded from ASC Pay (Add. EE)
- ASC payment status
- Excluded from ASC payment
- CMS addendum
- EE (Excluded)
- Typical setting
- Hospital outpatient department (POS 22) or office (POS 11). Not separately payable in an ASC.
What is CPT code 99471?
CPT 99471 is a CPT/HCPCS (Add. EE) procedure code. Its official CMS short descriptor is "Ped critical care initial". In the ASC context it is grouped under Excluded from ASC Pay (Add. EE).
Is CPT 99471 payable in an ambulatory surgery center (ASC)?
CPT 99471 is on CMS Addendum EE, the list of procedures excluded from ASC payment. Medicare does not pay for it in the ASC setting; it is typically performed in a hospital outpatient department (HOPD) or office instead.
Where is CPT 99471 typically performed?
Hospital outpatient department (POS 22) or office (POS 11). Not separately payable in an ASC.
Reference information compiled from the CMS April 2026 ASC payment addenda (AA, BB, EE). Codes, descriptors, and ASC payment status change with each CMS update. This is a coding reference, not billing, coding, or legal advice. Always verify against the current CMS addenda and individual payer policy before billing. CPT is a registered trademark of the American Medical Association.