CPT 99091
Global XXX ActiveCollj & interpj data ea 30 d
CPT 99091 Billing & Documentation Guide
CPT code 99091 (Collj & interpj data ea 30 d) is classified under Misc Services with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.1, a non-facility practice expense RVU of 0.49, and a malpractice RVU of 0.07, a total non-facility RVU of 1.66 and facility RVU of 1.42. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $56.57, though rates vary from $52 to $73.83 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 99091, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 99091 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 99091 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 99091
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.1 | 1.1 |
| Practice Expense RVU | 0.49 | 0.25 |
| Malpractice RVU | 0.07 | 0.07 |
| Total RVU | 1.66 | 1.42 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 99091
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $58.69 | $49.21 | $56.56 - $65.64 | 29 |
| Florida | $57.71 | $49.67 | $55.9 - $59.69 | 3 |
| Georgia | $55.21 | $47.56 | $54.13 - $56.29 | 2 |
| Illinois | $57.15 | $49.41 | $55.34 - $58.81 | 4 |
| Michigan | $55.4 | $47.87 | $54.32 - $56.48 | 2 |
| North Carolina | $53.5 | $46.03 | $53.5 - $53.5 | 1 |
| New York | $59.92 | $50.98 | $53.93 - $62.89 | 5 |
| Ohio | $54.04 | $46.72 | $54.04 - $54.04 | 1 |
| Pennsylvania | $55.6 | $47.75 | $53.97 - $57.23 | 2 |
| Texas | $55.23 | $47.33 | $53.81 - $56.5 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 99091
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 99091 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0206T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0578T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93241 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93242 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93243 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93244 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93245 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93246 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 99091
What does CPT code 99091 mean? +
CPT code 99091 represents: Collj & interpj data ea 30 d. It's in the Misc Services category with a global period of XXX.
What is the Medicare reimbursement for CPT 99091? +
The 2026 Medicare national average non-facility payment for CPT 99091 is $56.57. Rates range from $52 to $73.83 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 99091? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 99091? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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