CPT code 99307: Nursing facility visit, subsequent visit, straightforward MDM2026 Medicare rate & RVUs in Maryland
Report this subsequent nursing facility visit for an encounter supported by straightforward medical decision making or at least 10 minutes of practitioner time.
Medicare pays $42.39–$46.57 for 99307 in the office in Maryland, from Rest of Maryland to Washington, DC area. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 99307 covers
This is a subsequent evaluation and management visit for a patient in a skilled nursing facility or nursing facility. It may involve assessing a minor, self-limited symptom, reviewing the patient's condition with facility staff, and deciding whether any change in care is needed. Physicians, geriatricians, nurse practitioners, and physician assistants commonly perform these visits during facility rounds. The level depends on the work performed, not simply on whether the visit was scheduled or brief.
Select 99307 using straightforward medical decision making or at least 10 minutes of the billing practitioner's total time on the encounter date. Count qualifying chart review, discussion with facility staff, evaluation, and documentation performed by that practitioner. For decision-making selection, document the problem addressed and the data and management risk considered; a specific amount of data review is not required. Under Medicare, the principal physician of record reports initial nursing facility care, while another practitioner's first visit during the admission may be subsequent care. Use the place of service that reflects the setting: POS 31 for a skilled nursing facility or POS 32 for a nursing facility. Medicare uses facility practice expense for POS 31 and non-facility practice expense for POS 32.
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 99307 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$42.39 to $46.57
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $44.10 | $38.72 |
| Rest of Maryland | $42.39 | $37.32 |
| Washington, DC area | $46.57 | $40.67 |
How the 99307 rate is calculated
Each of 99307’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 · 99307
RVUs × geographic indexes × conversion factor
Work0.70
0.70 RVUs× 1.000 GPCI
Practice expense0.51
0.51 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
1.2600
Conversion factor
$33.4009
Medicare rate
$42.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99307
99307 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 · 99307
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$42.09
- Non-facility (office)
- $42.09
- Facility
- $37.07
Higher because the practice carries its own overhead.
99307 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 99308Nursing facility visitSubsequent visit, low MDM
- 99307 is supported by straightforward MDM or at least 10 minutes; 99308 is supported by low MDM or at least 20 minutes. Select the level using the documented MDM or total time.
- 99304Nursing facility careInitial, straightforward or low complexity
- 99304 is initial nursing facility care with straightforward or low MDM. Under Medicare, the principal physician of record reports initial care; another practitioner's first visit during the admission may be reported as subsequent care.
- 99347Home visitEstablished patient, straightforward MDM
- 99347 is for an established patient seen at home or in a residence such as assisted living; 99307 is for care in a skilled nursing facility or nursing facility.
- 99315Discharge management30 minutes or less
- 99315 is nursing facility discharge management taking 30 minutes or less. Use 99307 for a subsequent evaluation that is not the practitioner's discharge management work.
99307 billing questions
When should 99307 be chosen instead of 99308?
Choose 99307 for straightforward MDM or at least 10 minutes when selecting by time. Choose 99308 for low MDM or at least 20 minutes when selecting by time; 20 minutes does not prevent selection of 99307 based on straightforward MDM.
Can 99307 be billed for a practitioner's first visit during the admission?
Yes, when that practitioner is not the principal physician of record. Under Medicare, the principal physician of record reports initial nursing facility care; other practitioners report subsequent care for their visits, including a first visit.
Does 99307 apply in assisted living facilities?
No. An established patient visit in assisted living is reported from the home or residence visit series, such as 99347 when its level criteria are met.
What counts toward the 10-minute threshold?
Count qualifying time personally spent by the billing practitioner on the encounter date, including evaluation, chart review, care-related discussions with staff or family, ordering, and documentation. Do not count time spent solely by facility nursing staff.
Can 99307 be billed for work performed as discharge management?
Report nursing facility discharge management with 99315 or 99316, according to time, rather than counting that work as a routine subsequent visit. The practitioner's discharge management visit may occur the day before the patient's actual discharge.
Which place of service code should accompany 99307?
Use POS 31 for care in a skilled nursing facility and POS 32 for care in a nursing facility. Medicare applies facility practice expense at POS 31 and non-facility practice expense at POS 32.
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
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