CPT code 99238: Hospital discharge, 30 minutes or less2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 99238 in California.

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

What 99238 covers

This service covers management of a hospital inpatient or observation discharge on a calendar date after admission. The discharging physician or qualified health care professional may perform a final evaluation, discuss the hospital course and continuing care with the patient or caregivers, reconcile medications, prepare prescriptions and referrals, arrange follow-up, and complete discharge records. Hospitalists and other practitioners responsible for the stay commonly perform this work in the hospital.

Choose 99238 when discharge management takes 30 minutes or less; use 99239 when documented discharge-date time exceeds 30 minutes. Count discharge work performed throughout that date, including preparation of the summary, even when the work is not continuous. If time is not documented, report 99238 rather than the higher-time code. The practitioner responsible for discharge reports one discharge management service; other practitioners who provide medically necessary visits select subsequent hospital inpatient or observation care as appropriate. The record should identify the discharge date and support the evaluation, instructions, medications, and follow-up arrangements.

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 99238 pays more and less in California

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

29 of 29 payment localities

How the 99238 rate is calculated

Each of 99238’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.

Payment rules and modifiers for 99238

99238 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.

99238 compared with similar codes

How to choose

99239Hospital discharge dayMore than 30 minutes

Both report hospital inpatient or observation discharge management. Use 99239 when documented discharge-date time exceeds 30 minutes; use 99238 for 30 minutes or less, or when time is not documented.

99234Hospital careSame-day admission and discharge

99234 combines admission and discharge care on the same calendar date and may be used for a qualifying Medicare stay of at least eight hours. Use 99238 when discharge occurs on a later calendar date.

99232Subsequent hospital visitModerate MDM or 35 minutes

99232 reports a moderate-level subsequent hospital inpatient or observation visit selected by MDM or time. 99238 is for the practitioner managing the discharge.

99315Discharge management30 minutes or less

99315 reports discharge management for a nursing facility resident; 99238 reports discharge management for a hospital inpatient or observation patient.

Codes related to 99238

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

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

Open CMS sourceHow we calculate rates