CPT code 99306: Nursing facility visit, initial visit, high complexity2026 Medicare rate & RVUs in Atlanta, GA

An initial skilled nursing or nursing facility evaluation is reported at this level when high medical decision making or at least 50 minutes supports it.

CMS RVU26DEffective Oct 1, 2026One payment locality1.3M Medicare services in 2024

In Atlanta, GA, Medicare pays $196.05 for 99306 in the office and $165.85 when it’s performed in a hospital or facility.

$196.05Office (non-facility)
$165.85Hospital or facility
+1.5%vs the national office rate ($193.06)

Check a contract rate as a % of Medicare · 99306 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 99306 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Atlanta, GA
  2. What 99306 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 99306 covers

Code 99306 covers an initial evaluation in a skilled nursing facility (SNF) or nursing facility when high medical decision making (MDM) or qualifying time supports the level. A practitioner may assess a resident after hospitalization for sepsis, stroke with swallowing problems, or worsening heart failure; those diagnoses alone do not establish high MDM. The visit may include reviewing hospital records, reconciling medications, examining the resident, and establishing a treatment plan. For Medicare SNF residents, a physician performs the required initial comprehensive visit; nurse practitioners and physician assistants may perform other medically necessary visits. In a nursing facility, an eligible practitioner not employed by the facility may perform the required initial comprehensive visit when permitted.

Select 99306 by high MDM, which requires two of three elements—problems, data, and risk—or by at least 50 minutes of the reporting practitioner's time on the encounter date. Document the clinical problems, data assessed, management decisions, or personally performed time. Exclude staff time and time spent on separately reported services. The principal physician of record appends Medicare modifier AI to the initial visit; other practitioners' qualifying initial visits are reported without AI. Later visits during the stay use subsequent nursing facility codes. Medicare prolonged time may be reported with G0317 when its threshold is met and 99306 was selected by time.

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 Atlanta, GA compares for 99306

Across 109 of 109 payment localities, the office rate for 99306 runs from $179.68 in Arkansas to $252.51 in Alaska. Atlanta, GA pays $196.05. The RVUs are the same everywhere; the geographic indexes change the dollars.

99306 in Atlanta, GA vs other payment areas
  1. Atlanta, GA · this page$196.05
  2. Rest of Georgia · Georgia$187.14−$8.91
  3. Los Angeles, CA · California$207.80+$11.75
  4. Washington, DC area · District of Columbia$212.43+$16.38
  5. Miami, FL · Florida$207.61+$11.56
  6. Chicago, IL · Illinois$204.17+$8.12
  7. Manhattan, NY · New York$216.13+$20.08

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

Every other payment area

99306 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$252.51$220.85
AlabamaAlabama$181.16$155.15
ArkansasArkansas$179.68$154.14
ArizonaArizona$189.83$161.02
Bakersfield, CACalifornia$198.85$166.27
Chico, CACalifornia$198.05$165.47
El Centro, CACalifornia$198.09$165.51
Fresno, CACalifornia$198.05$165.47

99306 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.

$179.68

$252.51

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

View every state and territory as a table
99306 office rate range by state
State / territoryOffice rate rangeLocalities
AK$252.511
AL$181.161
AR$179.681
AZ$189.831
CA$198.05–$232.6229
CO$197.161
CT$202.281
DC$212.431
DE$192.041
FL$193.91–$207.613
GA$187.14–$196.052
GU$199.201
HI$199.201
IA$182.601
ID$183.531
IL$191.43–$204.174
IN$184.111
KS$182.671
KY$184.801
LA$184.86–$190.062
MA$197.00–$210.292
MD$194.42–$212.433
ME$184.68–$189.612
MI$188.09–$195.932
MN$189.631
MO$183.41–$189.793
MS$181.531
MT$193.041
NC$185.701
ND$188.491
NE$183.011
NH$194.901
NJ$204.78–$211.902
NM$188.921
NV$191.841
NY$187.35–$220.065
OH$187.161
OK$184.021
OR$190.50–$200.562
PA$187.02–$199.452
PR$193.701
RI$196.711
SC$186.701
SD$187.961
TN$183.271
TX$186.35–$196.408
UT$188.171
VA$189.63–$212.432
VI$193.701
VT$188.581
WA$196.37–$213.042
WI$184.871
WV$187.401
WY$191.061

See 99306 in every payment locality

How the 99306 rate is calculated

Each of 99306’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 · 99306

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.50

3.50 RVUs× 1.000 GPCI

Practice expense2.05

2.05 RVUs× 1.000 GPCI

Malpractice0.23

0.23 RVUs× 1.000 GPCI

Adjusted RVUs

5.7800

Conversion factor

$33.4009

Medicare rate

$193.06

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

The exact Atlanta, GA inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,047

Code
99306
Physician work
3.50
Practice expense
2.05
Malpractice
0.23

GPCI2026.csv

44

Locality
Atlanta, GA
Physician work
1.003
Practice expense
1.016
Malpractice
1.201
Office calculation for 99306 in Atlanta, GA
ComponentRVULocality factorAdjusted
Physician work3.50× 1.0033.5105
Practice expense2.05× 1.0162.0828
Malpractice0.23× 1.2010.2762
Total RVUs5.8695
Conversion factor× 33.4009

Office rate, Atlanta, GA$196.05

Office: (3.5 × 1.003 + 2.05 × 1.016 + 0.23 × 1.201) × $33.4009 = $196.05

Facility: (3.5 × 1.003 + 1.16 × 1.016 + 0.23 × 1.201) × $33.4009 = $165.85

Open 99306 in the RVU calculator

Payment rules and modifiers for 99306

99306 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 · 99306

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$193.06

Non-facility (office)
$193.06
Facility
$163.33

Higher because the practice carries its own overhead.

How 99306 has changed in Atlanta, GA

99306 · Office / nonfacility

$196.05

Effective 2026-10-01

The base rate is $19.99 higher than on 2025-10-01, moving from $176.06 to $196.05 (11.4%).

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

    $176.06changed to$196.05

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.70 changed to 2.05
    • Malpractice RVU 0.22 changed to 0.23
    • Work GPCI 1.000 changed to 1.003
    • Practice expense GPCI 0.997 changed to 1.016
    • Malpractice GPCI 1.128 changed to 1.201

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $181.23changed to$176.06

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.69 changed to 1.70
    • Malpractice RVU 0.23 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $178.27changed to$181.23

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $182.32changed to$178.27

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.66 changed to 1.69
    • Malpractice RVU 0.22 changed to 0.23
    • Practice expense GPCI 0.998 changed to 0.997
    • Malpractice GPCI 1.016 changed to 1.128
  5. January 1, 2023

    RVU23A

    $163.96changed to$182.32

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 3.06 changed to 3.50
    • Practice expense RVU 1.50 changed to 1.66
    • Malpractice RVU 0.20 changed to 0.22
    • Malpractice GPCI 0.904 changed to 1.016

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $165.66changed to$163.96

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.51 changed to 1.50

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $169.85changed to$165.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.46 changed to 1.51
    • Malpractice RVU 0.19 changed to 0.20
    • Malpractice GPCI 0.996 changed to 0.904

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $169.83changed to$169.85

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.45 changed to 1.46
    • Practice expense GPCI 0.997 changed to 0.998
    • Malpractice GPCI 1.088 changed to 0.996

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $170.36changed to$169.83

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.47 changed to 1.45

    Held through RVU19B, RVU19C, RVU19D.

  10. April 1, 2018

    RVU18B

    No ratechanged to$170.36

    Held through RVU18C, RVU18D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$196.05$165.85RVU26D
2026-07-01$196.05$165.85RVU26C
2026-04-01$196.05$165.85RVU26B
2026-01-01$196.05$165.85RVU26A
2025-10-01$176.06$176.06RVU25D
2025-07-01$176.06$176.06RVU25C
2025-04-01$176.06$176.06RVU25B
2025-01-01$176.06$176.06RVU25A
2024-10-01$181.23$181.23RVU24D
2024-07-01$181.23$181.23RVU24C
2024-04-01$181.23$181.23RVU24B
2024-03-09$181.23$181.23RVU24AR
2024-01-01$178.27$178.27RVU24A
2023-10-01$182.32$182.32RVU23D
2023-07-01$182.32$182.32RVU23C
2023-04-01$182.32$182.32RVU23B
2023-01-01$182.32$182.32RVU23A
2022-10-01$163.96$163.96RVU22D
2022-07-01$163.96$163.96RVU22C
2022-04-01$163.96$163.96RVU22B
2022-01-01$163.96$163.96RVU22A
2021-10-01$165.66$165.66RVU21D
2021-07-01$165.66$165.66RVU21C
2021-04-01$165.66$165.66RVU21B
2021-01-01$165.66$165.66RVU21A
2020-10-01$169.85$169.85RVU20D
2020-07-01$169.85$169.85RVU20C
2020-04-01$169.85$169.85RVU20B
2020-01-01$169.85$169.85RVU20A
2019-10-01$169.83$169.83RVU19D
2019-07-01$169.83$169.83RVU19C
2019-04-01$169.83$169.83RVU19B
2019-01-01$169.83$169.83RVU19A
2018-10-01$170.36$170.36RVU18D
2018-07-01$170.36$170.36RVU18C
2018-04-01$170.36$170.36RVU18B
2018-01-01Rate data unavailableRate data unavailableRVU18AR1
2017-10-01Rate data unavailableRate data unavailableRVU17D
2017-07-01Rate data unavailableRate data unavailableRVU17C
2017-04-01Rate data unavailableRate data unavailableRVU17B
2017-01-01Rate data unavailableRate data unavailableRVU17A
2016-10-01Rate data unavailableRate data unavailableRVU16D
2016-07-01Rate data unavailableRate data unavailableRVU16C
2016-04-01Rate data unavailableRate data unavailableRVU16B
2016-01-01Rate data unavailableRate data unavailableRVU16A
2015-10-01Rate data unavailableRate data unavailableRVU15D
2015-07-01Rate data unavailableRate data unavailableRVU15C
2015-04-01Rate data unavailableRate data unavailableRVU15B
2015-01-01Rate data unavailableRate data unavailableRVU15A
2014-10-01Rate data unavailableRate data unavailableRVU14D
2014-07-01Rate data unavailableRate data unavailableRVU14C
2014-04-01Rate data unavailableRate data unavailableRVU14B
2014-01-01Rate data unavailableRate data unavailableRVU14A
2013-10-01Rate data unavailableRate data unavailableRVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 99306 for an earlier date of service

Where the Atlanta, GA rate applies

Atlanta, GA is a Medicare payment area, not a city. Our Census mapping connects it to 114 cities and communities in Georgia. Some span more than one payment area; confirm with the service ZIP.

  • Atlanta
  • Acworth
  • Alpharetta
  • 99306 in Auburn · multiple payment areas
  • Austell
  • Avondale Estates
  • Ball Ground
  • Belvedere Park

Browse all communities in Georgia

99306 billing questions

When should 99306 be chosen over 99305?

Both are initial nursing facility visits. Choose 99306 for high MDM or at least 50 minutes of qualifying time; 99305 requires moderate MDM or at least 35 minutes. When selecting by MDM, document the elements supporting the higher level.

What is modifier AI and when is it appended?

For Medicare, modifier AI identifies the principal physician of record on an initial nursing facility visit. Other practitioners who perform qualifying initial visits report them without AI.

Can a nurse practitioner bill 99306?

A physician must perform the required initial comprehensive visit for a Medicare SNF resident, but a nurse practitioner may report another medically necessary initial visit when supported. In a nursing facility, a qualified nurse practitioner not employed by the facility may perform the required initial comprehensive visit when permitted.

How is prolonged time reported with 99306?

Medicare uses G0317 when the applicable prolonged-service threshold is met; payers following CPT may use 99418. The primary visit must be selected by time, and the prolonged-service requirements must also be met.

Can 99306 be billed if the patient was seen by the same practitioner earlier in the stay?

After that practitioner's initial visit, later visits during the same stay are reported with subsequent nursing facility codes 99307–99310. A new admission after discharge may support another initial visit.

Does activity on other days count toward the 50 minutes?

No. Count only the reporting practitioner's qualifying time on the encounter date, such as chart review, examination, orders, and documentation. Exclude facility staff time and time spent on separately reported services.

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 99306PPRRVU2026_Oct_nonQPP.csv, line 13,047 (RVU26D)
Geographic factors for Atlanta, GAGPCI2026.csv, line 44 (RVU26D)

Open CMS sourceHow we calculate rates

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