CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Telehealth
99422 — Online digital E/M, established patient; 11-20 minutes cumulative over 7 days
This code is billed when a physician spends 11 to 20 cumulative minutes over a 7-day period managing an established patient's healthcare via secure electronic communication — such as a patient portal with medical deci...
- Typical setting: Online (asynchronous)
- National avg charge (illustrative): $30-$60 Medicare allowed (approx. $30-$50 national Medicare average; commercial payers $45-$80)
- Most-disputed reason: Billing 99422 and 99421 for the same 7-day period: only one code in the 99421-99423 series is billable per 7-day encounter period
What it means
What 99422 actually means
This code is billed when a physician spends 11 to 20 cumulative minutes over a 7-day period managing an established patient's healthcare via secure electronic communication — such as a patient portal with medical decision-making involved. The time must include physician time reviewing records and composing responses, not just the time the patient spends composing the message.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 99422 and 99421 for the same 7-day period: only one code in the 99421-99423 series is billable per 7-day encounter period
- Billing for administrative messages: billing 99422 for messages requesting prescription refills, appointment scheduling, or results not requiring interpretation — these are not billable clinical services
- Missing documentation of total time: insufficient records of cumulative physician time across the 7-day period to support the 11-20 minute threshold
If you see 99422 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 99422 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 99422 on a bill.
99422 FAQ
Plain-English answers.
What does 99422 usually cost?
$30-$60 Medicare allowed (approx. $30-$50 national Medicare average; commercial payers $45-$80). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 99422?
Billing 99422 and 99421 for the same 7-day period: only one code in the 99421-99423 series is billable per 7-day encounter period
What should I do if I see 99422 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 99422 before paying.
Don't pay 99422 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.