Under the outpatient PPS, which CPT code can replace the code for a medical visit when critical care services are provided?

The correct choice is the CPT Code 99291, which is designated for critical care services. Critical care refers to the evaluation and management of a critically ill patient, typically requiring constant attention and immediate intervention. When critical care services are administered, they often supersede other codes related to standard medical visits because of the complexity and urgency of the care being provided.

In outpatient settings, if a provider performs critical care services, they must report those services using 99291. This code indicates that the medical visit involved a significant amount of time and resources for the critically ill patient, which justifies its use over codes for standard evaluations or visits.

Understanding the significance of the critical care codes is important in reimbursement practices because they reflect the intensity of care and complexity of the medical case, thus leading to appropriate compensation for the provider's efforts in managing high-acuity patients. Other codes listed, such as prolonged evaluation and management services or surgical procedures, do not specifically address the critical care context, making them unsuitable for replacement in this scenario.