CPT code 99304: Nursing facility care, initial, straightforward or low complexity2026 Medicare rate & RVUs in Kansas

Report this initial nursing facility evaluation when the documented medical decision making is straightforward or low complexity, or the service meets the 25-minute time threshold.

CMS RVU26DEffective Oct 1, 2026One payment locality342.1K Medicare services in 2024

In Kansas, Medicare pays $76.98 for 99304 in the office and $67.92 when it’s performed in a hospital or facility.

$76.98Office (non-facility)
$67.92Hospital or facility
−5.2%vs the national office rate ($81.16)

Check a contract rate as a % of Medicare · 99304 nationwide

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

We’ll open 99304 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Kansas
  2. What 99304 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 99304 covers

Code 99304 describes an initial evaluation and management service for a patient in a nursing facility, such as a skilled nursing facility or nursing home. A physician or other qualified health care professional assesses the patient’s condition and needs in that setting and establishes or updates the care plan. The patient may be new or established to the practitioner; the relevant distinction is that the service is initial nursing facility care, not a later follow-up visit.

Select this level when medical decision making is straightforward or low complexity, or when the practitioner’s total time on the date of service meets or exceeds 25 minutes. Document the medically appropriate history and examination, the problems addressed, the data reviewed or analyzed, and the management decisions; when selecting by time, document the qualifying time. CMS assigns work, practice-expense, and malpractice RVUs, with separate practice-expense values for office and facility settings.

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.

How Kansas compares for 99304

Across 109 of 109 payment localities, the office rate for 99304 runs from $75.75 in Arkansas to $106.69 in Alaska. Kansas pays $76.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

99304 in Kansas vs other payment areas
  1. Kansas · this page$76.98
  2. Los Angeles, CA · California$87.34+$10.36
  3. Washington, DC area · District of Columbia$89.20+$12.22
  4. Miami, FL · Florida$86.91+$9.93
  5. Chicago, IL · Illinois$85.55+$8.57
  6. Manhattan, NY · New York$90.68+$13.70
  7. Alaska · Alaska$106.69+$29.71

Other areas in Kansas first, then benchmark localities. Bars start at $0.

Every other payment area

99304 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$76.35$67.58
ArkansasArkansas$75.75$67.14
ArizonaArizona$79.86$70.15
Bakersfield, CACalifornia$83.63$72.65
Chico, CACalifornia$83.31$72.33
El Centro, CACalifornia$83.33$72.35
Fresno, CACalifornia$83.31$72.33
Hanford, CACalifornia$83.31$72.33

99304 rates by state

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

Explore a state

Local rates. Clear comparisons.

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

$75.75

$106.69

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
99304 office rate range by state
State / territoryOffice rate rangeLocalities
AK$106.691
AL$76.351
AR$75.751
AZ$79.861
CA$83.31–$97.6829
CO$82.901
CT$84.961
DC$89.201
DE$80.771
FL$81.44–$86.913
GA$78.71–$82.372
GU$83.741
HI$83.741
IA$76.971
ID$77.341
IL$80.42–$85.554
IN$77.571
KS$76.981
KY$77.791
LA$77.81–$79.922
MA$82.84–$88.332
MD$81.76–$89.203
ME$77.78–$79.802
MI$79.11–$82.242
MN$79.861
MO$77.21–$79.823
MS$76.481
MT$81.161
NC$78.201
ND$79.381
NE$77.131
NH$81.941
NJ$86.04–$89.012
NM$79.441
NV$80.691
NY$78.87–$92.255
OH$78.751
OK$77.491
OR$80.16–$84.312
PA$78.70–$83.802
PR$81.431
RI$82.721
SC$78.581
SD$79.171
TN$77.221
TX$78.43–$82.558
UT$79.171
VA$79.80–$89.202
VI$81.431
VT$79.401
WA$82.58–$89.492
WI$77.911
WV$78.781
WY$80.381

See 99304 in every payment locality

How the 99304 rate is calculated

Each of 99304’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 · 99304

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense0.84

0.84 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

2.4300

Conversion factor

$33.4009

Medicare rate

$81.16

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

The exact Kansas inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,045

Code
99304
Physician work
1.50
Practice expense
0.84
Malpractice
0.09

GPCI2026.csv

54

Locality
Kansas
Physician work
1.000
Practice expense
0.904
Malpractice
0.504
Office calculation for 99304 in Kansas
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0001.5000
Practice expense0.84× 0.9040.7594
Malpractice0.09× 0.5040.0454
Total RVUs2.3047
Conversion factor× 33.4009

Office rate, Kansas$76.98

Office: (1.5 × 1 + 0.84 × 0.904 + 0.09 × 0.504) × $33.4009 = $76.98

Facility: (1.5 × 1 + 0.54 × 0.904 + 0.09 × 0.504) × $33.4009 = $67.92

Open 99304 in the RVU calculator

Payment rules and modifiers for 99304

99304 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 · 99304

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$81.16

Non-facility (office)
$81.16
Facility
$71.14

Higher because the practice carries its own overhead.

How 99304 has changed in Kansas

99304 · Office / nonfacility

$76.98

Effective 2026-10-01

The base rate is $3.51 higher than on 2025-10-01, moving from $73.47 to $76.98 (4.8%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $73.47changed to$76.98

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.78 changed to 0.84
    • Malpractice RVU 0.12 changed to 0.09
    • Practice expense GPCI 0.906 changed to 0.904
    • Malpractice GPCI 0.540 changed to 0.504

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $75.43changed to$73.47

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $74.20changed to$75.43

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $76.36changed to$74.20

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.77 changed to 0.78
    • Practice expense GPCI 0.907 changed to 0.906
    • Malpractice GPCI 0.499 changed to 0.540
  5. January 1, 2023

    RVU23A

    $84.26changed to$76.36

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.64 changed to 1.50
    • Practice expense RVU 0.82 changed to 0.77
    • Practice expense GPCI 0.908 changed to 0.907
    • Malpractice GPCI 0.458 changed to 0.499

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $84.96changed to$84.26

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $87.59changed to$84.96

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.80 changed to 0.82
    • Practice expense GPCI 0.910 changed to 0.908
    • Malpractice GPCI 0.536 changed to 0.458

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $87.37changed to$87.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.78 changed to 0.80
    • Malpractice RVU 0.12 changed to 0.11
    • Practice expense GPCI 0.911 changed to 0.910
    • Malpractice GPCI 0.615 changed to 0.536

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $88.70changed to$87.37

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.83 changed to 0.78
    • Malpractice RVU 0.11 changed to 0.12

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $88.40changed to$88.70

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 0.907 changed to 0.911
    • Malpractice GPCI 0.639 changed to 0.615

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $88.16changed to$88.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 0.903 changed to 0.907
    • Malpractice GPCI 0.662 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $88.48changed to$88.16

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $88.04changed to$88.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $89.57changed to$88.04

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.84 changed to 0.83
    • Malpractice RVU 0.13 changed to 0.11
    • Practice expense GPCI 0.899 changed to 0.903
    • Malpractice GPCI 0.810 changed to 0.662

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $88.04changed to$89.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.91 changed to 0.84
    • Malpractice RVU 0.14 changed to 0.13
    • Practice expense GPCI 0.894 changed to 0.899
    • Malpractice GPCI 0.957 changed to 0.810

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $88.04

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$76.98$67.92RVU26D
2026-07-01$76.98$67.92RVU26C
2026-04-01$76.98$67.92RVU26B
2026-01-01$76.98$67.92RVU26A
2025-10-01$73.47$73.47RVU25D
2025-07-01$73.47$73.47RVU25C
2025-04-01$73.47$73.47RVU25B
2025-01-01$73.47$73.47RVU25A
2024-10-01$75.43$75.43RVU24D
2024-07-01$75.43$75.43RVU24C
2024-04-01$75.43$75.43RVU24B
2024-03-09$75.43$75.43RVU24AR
2024-01-01$74.20$74.20RVU24A
2023-10-01$76.36$76.36RVU23D
2023-07-01$76.36$76.36RVU23C
2023-04-01$76.36$76.36RVU23B
2023-01-01$76.36$76.36RVU23A
2022-10-01$84.26$84.26RVU22D
2022-07-01$84.26$84.26RVU22C
2022-04-01$84.26$84.26RVU22B
2022-01-01$84.26$84.26RVU22A
2021-10-01$84.96$84.96RVU21D
2021-07-01$84.96$84.96RVU21C
2021-04-01$84.96$84.96RVU21B
2021-01-01$84.96$84.96RVU21A
2020-10-01$87.59$87.59RVU20D
2020-07-01$87.59$87.59RVU20C
2020-04-01$87.59$87.59RVU20B
2020-01-01$87.59$87.59RVU20A
2019-10-01$87.37$87.37RVU19D
2019-07-01$87.37$87.37RVU19C
2019-04-01$87.37$87.37RVU19B
2019-01-01$87.37$87.37RVU19A
2018-10-01$88.70$88.70RVU18D
2018-07-01$88.70$88.70RVU18C
2018-04-01$88.70$88.70RVU18B
2018-01-01$88.70$88.70RVU18AR1
2017-10-01$88.40$88.40RVU17D
2017-07-01$88.40$88.40RVU17C
2017-04-01$88.40$88.40RVU17B
2017-01-01$88.40$88.40RVU17A
2016-10-01$88.16$88.16RVU16D
2016-07-01$88.16$88.16RVU16C
2016-04-01$88.16$88.16RVU16B
2016-01-01$88.16$88.16RVU16A
2015-10-01$88.48$88.48RVU15D
2015-07-01$88.48$88.48RVU15C
2015-04-01$88.04$88.04RVU15B
2015-01-01$88.04$88.04RVU15A
2014-10-01$89.57$89.57RVU14D
2014-07-01$89.57$89.57RVU14C
2014-04-01$89.57$89.57RVU14B
2014-01-01$89.57$89.57RVU14A
2013-10-01$88.04$88.04RVU13D
2013-07-01$88.04$88.04RVU13C
2013-04-01$88.04$88.04RVU13B
2013-01-01$88.04$88.04RVU13AR

Price 99304 for an earlier date of service

Where the Kansas rate applies

Kansas is a Medicare payment area, not a city. Our Census mapping connects it to 740 cities and communities in Kansas. Some span more than one payment area; confirm with the service ZIP.

  • Abbyville
  • Abilene
  • Ada
  • Admire
  • Agenda
  • Agra
  • Albert
  • Alden

Browse all communities in Kansas

99304 billing questions

When should 99304 be chosen over 99305?

Use 99304 for an initial nursing facility service when medical decision making is straightforward or low complexity, or when selecting by time at the 25-minute threshold. Use 99305 when the documented medical decision making is moderate complexity or the applicable time threshold is met.

Does the patient have to be new to the practitioner?

No. The code is for initial nursing facility care and is not determined by whether the patient has previously seen that practitioner.

Can the level be selected by time?

Yes. The practitioner’s total time on the date of service must meet or exceed 25 minutes. Document the qualifying time and the work performed.

How does 99304 differ from a subsequent nursing facility visit?

99304 represents initial nursing facility care. For a later follow-up service in the facility, select the applicable subsequent nursing facility care level, such as 99307 or 99308.

What documentation supports 99304?

Document the clinical issues evaluated, the medically appropriate history and examination, and the reasoning behind the straightforward or low-complexity decisions. If selecting by time, document the total qualifying time on the date of service.

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 99304PPRRVU2026_Oct_nonQPP.csv, line 13,045 (RVU26D)
Geographic factors for KansasGPCI2026.csv, line 54 (RVU26D)

Open CMS sourceHow we calculate rates

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