CPT 99422: Online Digital E/M, 11-20 Minutes
CPT 99422 reports a patient-initiated online digital E/M (e-visit) with 11-20 minutes of cumulative provider time over a 7-day period. In 2026 Medicare pays about $30.73 non-facility (0.92 total RVUs times the $33.4009 conversion factor) and about $22.38 in a facility.
- Code type
- Online digital E/M (e-visit)
- 2026 non-facility
- $30.73 (0.92 RVUs)
- 2026 facility
- $22.38 (0.67 RVUs)
- Time
- 11-20 min cumulative over 7 days
What is CPT 99422 used for?
CPT 99422 is the middle-tier online digital E/M (e-visit) code for an established patient, covering 11-20 minutes of cumulative provider time over a 7-day period. Use it when a patient-initiated portal exchange requires meaningful clinical evaluation and time, more than a quick reply but short of the longest tier.
Cumulative time includes reviewing the inquiry, reviewing records, clinical decision making, and generating the response, plus related orders and prescriptions, tallied across every interaction in the window. The service is limited to established patients who initiate the exchange, and the inquiry cannot relate to an E/M service from the prior 7 days or fall inside a procedure's global period.
How much does 99422 pay in 2026?
99422 carries 0.92 non-facility RVUs and 0.67 facility RVUs. At the 2026 conversion factor of $33.4009 that is about $30.73 non-facility and $22.38 in a facility, roughly double the entry tier. Confirm locality rates with the Medicare fee calculator.
How do you bill the e-visit tiers correctly?
The three codes differ only by cumulative 7-day time:
Example: a patient with worsening reflux messages twice over five days; the provider reviews prior labs, adjusts the regimen, and documents a running total of 15 minutes. That maps to 99422, not two 99421 charges. When the payer treats the exchange as telehealth, append modifier 95 per its policy. If the running total had stopped at 9 minutes it would drop to 99421; if it had climbed past 20 it would rise to 99423, which is why the cumulative log, not any single message, sets the code.
Frequently asked questions
99422 requires 11-20 minutes of cumulative physician or QHP time over the 7-day e-visit period. Cumulative time includes reviewing the inquiry, reviewing records, clinical decision making, and generating the response, plus related orders and prescriptions, tallied across all interactions in the window.
The 2026 national non-facility allowed amount is about $30.73 (0.92 total RVUs times $33.4009) and about $22.38 in a facility. This is the middle of the three e-visit tiers.
No. Online digital E/M codes are for established patients only. The patient must have an existing relationship with the practice and must initiate the online inquiry. New-patient e-visits are not separately reportable with this family, and the inquiry cannot relate to an E/M service from the prior 7 days.
Sources & further reading
Reviewed by the ImmediCare Solutions RCM team
Certified billers and coders handling claims across 50+ specialties nationwide. This entry is reviewed against current payer policy and CMS rules. Last review: Jul 5, 2026.
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