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CPT code 99232: Subsequent hospital visit, moderate MDM or 35 minutes2026 Medicare rate & RVUs

Report a subsequent inpatient or observation visit when the practitioner's follow-up care meets moderate medical decision making or at least 35 minutes of total time.

CMS RVU26DEffective Oct 1, 2026109 payment localities34.7M Medicare services in 2024

Medicare pays $70.48 for 99232 nationally in a facility.

Medicare rate · 99232

Subsequent hospital visit, moderate MDM or 35 minutes

Office or facility?

Work RVUs
1.59
Total RVUs
2.11
Global days
XXX

National rate · 2026

$70.48

Facility setting, before claim adjustments.

See every locality for 99232 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 99232 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 99232 covers

A physician or qualified nonphysician practitioner reports this level when following a patient receiving hospital inpatient or observation care. Hospitalists, internists, cardiologists, and nephrologists may use it while managing conditions such as heart failure, pneumonia, or acute kidney injury. The condition alone does not determine the level; the documented work must support moderate medical decision making (MDM), or the practitioner must meet the time requirement. Medicare reports this code predominantly in the facility setting.

Select 99232 by moderate MDM or at least 35 minutes of the billing practitioner's total time on the date of service, including qualifying work away from the unit. When selecting by MDM, document the problems addressed, data reviewed or analyzed, and management risk; at least two MDM elements must reach the moderate level. When selecting by time, document the total time. Practitioners in the same specialty and group generally report one hospital E/M visit per patient per day. For a split or shared visit by a physician and nonphysician practitioner in the same group, the practitioner who performed the substantive portion bills with modifier FS.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 99232 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99232 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$67.07
AlaskaUnavailable$96.10
ArizonaUnavailable$69.48
ArkansasUnavailable$66.65
Atlanta, GAUnavailable$71.65
Austin, TXUnavailable$70.90
Bakersfield, CAUnavailable$71.20
Baltimore area, MDUnavailable$73.25
Beaumont, TXUnavailable$68.99
Brazoria, TXUnavailable$69.90

99232 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
99232 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 99232 rate is calculated

Each of 99232’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 99232

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.59

1.59 RVUs× 1.000 GPCI

Practice expense0.40

0.40 RVUs× 1.000 GPCI

Malpractice0.12

0.12 RVUs× 1.000 GPCI

Adjusted RVUs

2.1100

Conversion factor

$33.4009

Medicare rate

$70.48

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 99232

99232 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 99232

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

99232 isn’t priced in this setting.

99232 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 99232

    Subsequent hospital visit, moderate MDM or 35 minutes1.59 wRVU

    Not priced

  • 99214

    Office visit, established patient, moderate complexity1.92 wRVU

    $135.61

  • 99222

    Initial hospital visit, moderate MDM or 55 minutes2.6 wRVU

    Not priced

  • 99233

    Hospital follow-up visit, subsequent day, high complexity2.4 wRVU

    Not priced

  • 99254

    Hospital consultation, moderate, 60-minute level2.72 wRVU

    Not priced

How to choose

99214Office visitEstablished patient, moderate complexity
99214 is a moderate-level established patient office or outpatient visit. For a subsequent visit while the patient is receiving hospital inpatient or observation care, use 99232 when its MDM or time requirement is met.
99222Initial hospital visitModerate MDM or 55 minutes
99222 covers initial hospital care at moderate MDM or at least 55 minutes. 99232 applies to subsequent care after that practitioner or same-specialty group has provided initial hospital care.
99233Hospital follow-up visitSubsequent day, high complexity
Both describe subsequent hospital care. Use 99233 for high MDM or at least 50 minutes; use 99232 for moderate MDM or at least 35 minutes.
99254Hospital consultationModerate, 60-minute level
99254 describes a moderate-level inpatient or observation consultation for payers that recognize consultation codes. Medicare does not pay consultation codes; select subsequent hospital care by the documented MDM or time for a follow-up visit.

Codes related to 99232

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 99232
CodeHow it relatesNational office range
Same family
99231Subsequent hospital visit, straightforward or low MDM, 25 minutesLower subsequent hospital visit level for straightforward or low MDM or at least 25 minutes.No office rate
99233Hospital follow-up visit, subsequent day, high complexityHigher subsequent hospital visit level for high MDM or at least 50 minutes.No office rate
Used instead
99222Initial hospital visit, moderate MDM or 55 minutesInitial hospital care at moderate MDM or at least 55 minutes, rather than subsequent care.No office rate
99223Initial hospital visit, high decision making or 75 minutesHigh-level initial hospital care, rather than a subsequent visit.No office rate
99235Hospital care, same-day, moderate complexityModerate-level hospital care when admission and discharge occur on the same date.No office rate
99214Office visit, established patient, moderate complexityModerate-level established patient office or outpatient care rather than inpatient or observation care.$123.92–$170.02

99232 billing questions

How do I choose 99232 over 99231 or 99233?

Select the level supported by MDM or total time: 99231 for straightforward or low MDM or at least 25 minutes, 99232 for moderate MDM or at least 35 minutes, and 99233 for high MDM or at least 50 minutes. When selecting by time, report the highest level whose minimum is met.

Can 99232 be reported for an observation patient?

Yes. Subsequent hospital care codes cover both inpatient and observation status; the former separate subsequent observation codes were deleted.

What time counts toward the 35 minutes?

Count the billing practitioner's time on the date of service for work such as chart review, examination, medically appropriate family discussion, orders, care coordination, and documentation. Exclude clinical staff time and time spent on separately reported services.

Can prolonged services be added to 99232?

No. Among subsequent hospital care levels, prolonged time is reported only with 99233 when the applicable requirements are met. Select 99233 first if the documented time supports it.

How does a specialist report Medicare hospital follow-up visits?

Medicare does not pay inpatient consultation codes. After the specialist's initial hospital care visit, select 99231–99233 for follow-up care; use 99232 when moderate MDM or at least 35 minutes supports it.

Can 99232 be billed on the patient's discharge date?

A practitioner performing discharge-day management reports 99238 or 99239 instead of a subsequent care visit. A different specialist may report 99232 for a separate, medically necessary follow-up visit on that date.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 99232PPRRVU2026_Oct_nonQPP.csv, line 13,022 (RVU26D)

Open CMS sourceHow we calculate rates

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