How Much Does Critical Care (Each Additional 30 Minutes) Cost?
Also known as: Critical care addl 30 min (CPT 99292)
Additional critical care time beyond the first 74 minutes for patients in life-threatening condition.
Critical Care (Each Additional 30 Minutes) (CPT 99292) costs $100 at Medicare rates.
The rates shown below represent the complete Medicare reimbursement for this service. No separate facility fee applies for this type of procedure.
Patient Guide: Critical Care (Each Additional 30 Minutes)
What you need to know before your appointment
What to Expect
Continued intensive physician management for critically ill patients requiring ongoing direct care.
How Long Does It Take?
Each additional 30 minutes
Common Reasons Doctors Order This
Prolonged critical illness, complex trauma, ongoing resuscitation, multi-organ failure
How to Prepare
Family should remain available for updates and decisions.
Procedures Commonly Done Together
These procedures are frequently performed alongside Critical care addl 30 min
What Insurance Companies Actually Pay
Real negotiated rates from 9 hospitals across 5 states (from hospital price transparency filings)
| Insurance Company | Avg Rate | Range | Hospitals |
|---|---|---|---|
| Aetna | $3,964 | $137 - $15,317 | 9 |
| Cigna | $3,157 | $141 - $6,425 | 8 |
| United | $3,248 | $94 - $12,323 | 8 |
| BCBS | $5,249 | $17 - $7,960 | 4 |
| BCBS-TX | $242 | $166 - $359 | 2 |
| Humana | $360 | $102 - $1,222 | 6 |
| Kaiser | $2,520 | $1,111 - $5,318 | 2 |
| CHC | $258 | $16 - $738 | 2 |
| Anthem | $7,672 | $4,476 - $10,189 | 2 |
| UNITED | $89 | $16 - $253 | 2 |
| TCHP | $49 | $16 - $111 | 2 |
| Wellpoint | $17 | $16 - $22 | 1 |
How to Reduce Your Cost for Critical care addl 30 min
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($134) differs from the facility rate ($100). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (4.01) x CF ($33.40) = $134
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Critical care addl 30 min cost?
The Medicare facility rate for Critical care addl 30 min is $100. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Critical care addl 30 min cost without insurance?
Without insurance, the cost of Critical care addl 30 min can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Critical care addl 30 min?
Most commercial health insurance plans and Medicare cover Critical care addl 30 min when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.