CPT code 99307: Nursing facility visit, subsequent visit, straightforward MDM2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $42.25 for 99307 in the office and $37.18 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 99307 nationwide

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

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.

How Puerto Rico compares for 99307

Across 109 of 109 payment localities, the office rate for 99307 runs from $38.87 in Arkansas to $54.13 in Alaska. Puerto Rico pays $42.25. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99307 rates by state

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

See 99307 in every payment locality

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.

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.

Codes related to 99307

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

How 99307 has changed in Puerto Rico

Price 99307 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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