CPT code 99308: Nursing facility visit, subsequent visit, low MDM2026 Medicare rate & RVUs in Galveston, TX

Report a subsequent skilled nursing or nursing facility visit when the practitioner documents low medical decision making or at least 20 minutes of qualifying time.

CMS RVU26DEffective Oct 1, 2026One payment locality11.8M Medicare services in 2024

In Galveston, TX, Medicare pays $78.48 for 99308 in the office and $67.54 when it’s performed in a hospital or facility.

$78.48Office (non-facility)
$67.54Hospital or facility
−0.4%vs the national office rate ($78.83)

Check a contract rate as a % of Medicare · 99308 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 99308 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Galveston, TX
  2. What 99308 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 99308 covers

Physicians, nurse practitioners, and physician assistants report 99308 for a subsequent evaluation of a resident in a skilled nursing facility or nursing facility. The encounter may address ongoing conditions, a new uncomplicated illness, or a change in care needs. Managing two stable chronic illnesses can support the problem element of low medical decision making (MDM), but the overall MDM level depends on at least two of its three elements. Work may include reviewing nursing observations, examining the resident, discussing care with facility staff, and updating treatment orders.

Select 99308 when the documented MDM is low or the reporting practitioner spends at least 20 minutes on qualifying work on the encounter date. Count the practitioner's face-to-face and non-face-to-face E/M work, including chart review, staff discussions, orders, and documentation; exclude facility staff time and time spent on separately reported services. Document the problems and management decisions supporting MDM or the total time supporting time-based selection. Medicare uses the facility rate for place of service (POS) 31, skilled nursing facility, and the nonfacility rate for POS 32, nursing facility.

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 Galveston, TX compares for 99308

Across 109 of 109 payment localities, the office rate for 99308 runs from $72.91 in Arkansas to $101.46 in Alaska. Galveston, TX pays $78.48. The RVUs are the same everywhere; the geographic indexes change the dollars.

99308 in Galveston, TX vs other payment areas
  1. Galveston, TX · this page$78.48
  2. Austin, TX · Texas$80.51+$2.03
  3. Beaumont, TX · Texas$75.69−$2.79
  4. Brazoria, TX · Texas$78.29−$0.19
  5. Dallas, TX · Texas$78.71+$0.23
  6. Fort Worth, TX · Texas$78.41−$0.07
  7. Houston, TX · Texas$79.95+$1.47

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

Every other payment area

99308 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$76.90$66.44
Los Angeles, CACalifornia$85.70$72.66
Washington, DC areaDistrict of Columbia$87.30$74.31
Miami, FLFlorida$84.25$72.78
Chicago, ILIllinois$82.75$71.68
Manhattan, NYNew York$88.47$75.67
AlaskaAlaska$101.46$89.73
AlabamaAlabama$73.57$63.93

99308 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.

$72.91

$101.46

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

View every state and territory as a table
99308 office rate range by state
State / territoryOffice rate rangeLocalities
AK$101.461
AL$73.571
AR$72.911
AZ$77.431
CA$81.47–$96.8329
CO$80.861
CT$82.781
DC$87.301
DE$78.381
FL$78.73–$84.253
GA$75.80–$80.022
GU$82.191
HI$82.191
IA$74.431
ID$74.801
IL$77.48–$82.754
IN$75.061
KS$74.361
KY$74.971
LA$74.95–$77.262
MA$80.71–$86.662
MD$79.43–$87.303
ME$75.20–$77.552
MI$76.32–$79.512
MN$77.891
MO$74.24–$77.263
MS$73.581
MT$78.821
NC$75.671
ND$77.241
NE$74.641
NH$79.831
NJ$83.83–$86.982
NM$76.651
NV$78.411
NY$76.40–$90.085
OH$76.001
OK$74.731
OR$77.90–$82.472
PA$76.00–$81.472
PR$79.151
RI$80.441
SC$75.941
SD$77.051
TN$74.611
TX$75.69–$80.518
UT$76.591
VA$77.48–$87.302
VI$79.151
VT$77.181
WA$80.49–$87.942
WI$75.601
WV$75.691
WY$78.131

See 99308 in every payment locality

How the 99308 rate is calculated

Each of 99308’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 · 99308

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.30

1.30 RVUs× 1.000 GPCI

Practice expense0.98

0.98 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

2.3600

Conversion factor

$33.4009

Medicare rate

$78.83

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

The exact Galveston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,049

Code
99308
Physician work
1.30
Practice expense
0.98
Malpractice
0.08

GPCI2026.csv

101

Locality
Galveston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
0.828
Office calculation for 99308 in Galveston, TX
ComponentRVULocality factorAdjusted
Physician work1.30× 1.0081.3104
Practice expense0.98× 0.9930.9731
Malpractice0.08× 0.8280.0662
Total RVUs2.3498
Conversion factor× 33.4009

Office rate, Galveston, TX$78.48

Office: (1.3 × 1.008 + 0.98 × 0.993 + 0.08 × 0.828) × $33.4009 = $78.48

Facility: (1.3 × 1.008 + 0.65 × 0.993 + 0.08 × 0.828) × $33.4009 = $67.54

Open 99308 in the RVU calculator

Payment rules and modifiers for 99308

99308 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 · 99308

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$78.83

Non-facility (office)
$78.83
Facility
$67.80

Higher because the practice carries its own overhead.

How 99308 has changed in Galveston, TX

99308 · Office / nonfacility

$78.48

Effective 2026-10-01

The base rate is $6.46 higher than on 2025-10-01, moving from $72.02 to $78.48 (9.0%).

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

    $72.02changed to$78.48

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.84 changed to 0.98
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.000 changed to 0.993
    • Malpractice GPCI 0.855 changed to 0.828

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.07changed to$72.02

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.83 changed to 0.84
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $72.86changed to$74.07

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $74.91changed to$72.86

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.80 changed to 0.83
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.013 changed to 1.000
    • Malpractice GPCI 0.703 changed to 0.855
  5. January 1, 2023

    RVU23A

    $69.42changed to$74.91

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.16 changed to 1.30
    • Practice expense RVU 0.74 changed to 0.80
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.026 changed to 1.013
    • Malpractice GPCI 0.550 changed to 0.703

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $69.63changed to$69.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.73 changed to 0.74

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $71.07changed to$69.63

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.71 changed to 0.73
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.019 changed to 1.026
    • Malpractice GPCI 0.695 changed to 0.550

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $70.57changed to$71.07

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.70 changed to 0.71
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.011 changed to 1.019
    • Malpractice GPCI 0.839 changed to 0.695

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $71.22changed to$70.57

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.72 changed to 0.70

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $70.83changed to$71.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.71 changed to 0.72
    • Practice expense GPCI 1.012 changed to 1.011
    • Malpractice GPCI 0.897 changed to 0.839

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $70.81changed to$70.83

    • Conversion factor 35.8043 changed to 35.8887
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.013 changed to 1.012
    • Malpractice GPCI 0.955 changed to 0.897

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $70.38changed to$70.81

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $70.03changed to$70.38

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $69.77changed to$70.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.70 changed to 0.71
    • Malpractice RVU 0.07 changed to 0.06
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.005 changed to 1.013
    • Malpractice GPCI 0.970 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $67.92changed to$69.77

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.76 changed to 0.70
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 0.996 changed to 1.005
    • Malpractice GPCI 0.985 changed to 0.970

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $67.92

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$78.48$67.54RVU26D
2026-07-01$78.48$67.54RVU26C
2026-04-01$78.48$67.54RVU26B
2026-01-01$78.48$67.54RVU26A
2025-10-01$72.02$72.02RVU25D
2025-07-01$72.02$72.02RVU25C
2025-04-01$72.02$72.02RVU25B
2025-01-01$72.02$72.02RVU25A
2024-10-01$74.07$74.07RVU24D
2024-07-01$74.07$74.07RVU24C
2024-04-01$74.07$74.07RVU24B
2024-03-09$74.07$74.07RVU24AR
2024-01-01$72.86$72.86RVU24A
2023-10-01$74.91$74.91RVU23D
2023-07-01$74.91$74.91RVU23C
2023-04-01$74.91$74.91RVU23B
2023-01-01$74.91$74.91RVU23A
2022-10-01$69.42$69.42RVU22D
2022-07-01$69.42$69.42RVU22C
2022-04-01$69.42$69.42RVU22B
2022-01-01$69.42$69.42RVU22A
2021-10-01$69.63$69.63RVU21D
2021-07-01$69.63$69.63RVU21C
2021-04-01$69.63$69.63RVU21B
2021-01-01$69.63$69.63RVU21A
2020-10-01$71.07$71.07RVU20D
2020-07-01$71.07$71.07RVU20C
2020-04-01$71.07$71.07RVU20B
2020-01-01$71.07$71.07RVU20A
2019-10-01$70.57$70.57RVU19D
2019-07-01$70.57$70.57RVU19C
2019-04-01$70.57$70.57RVU19B
2019-01-01$70.57$70.57RVU19A
2018-10-01$71.22$71.22RVU18D
2018-07-01$71.22$71.22RVU18C
2018-04-01$71.22$71.22RVU18B
2018-01-01$71.22$71.22RVU18AR1
2017-10-01$70.83$70.83RVU17D
2017-07-01$70.83$70.83RVU17C
2017-04-01$70.83$70.83RVU17B
2017-01-01$70.83$70.83RVU17A
2016-10-01$70.81$70.81RVU16D
2016-07-01$70.81$70.81RVU16C
2016-04-01$70.81$70.81RVU16B
2016-01-01$70.81$70.81RVU16A
2015-10-01$70.38$70.38RVU15D
2015-07-01$70.38$70.38RVU15C
2015-04-01$70.03$70.03RVU15B
2015-01-01$70.03$70.03RVU15A
2014-10-01$69.77$69.77RVU14D
2014-07-01$69.77$69.77RVU14C
2014-04-01$69.77$69.77RVU14B
2014-01-01$69.77$69.77RVU14A
2013-10-01$67.92$67.92RVU13D
2013-07-01$67.92$67.92RVU13C
2013-04-01$67.92$67.92RVU13B
2013-01-01$67.92$67.92RVU13AR

Price 99308 for an earlier date of service

Where the Galveston, TX rate applies

Galveston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 16 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

  • Galveston
  • Bacliff
  • Bayou Vista
  • Bolivar Peninsula
  • Clear Lake Shores
  • Dickinson
  • 99308 in Friendswood · multiple payment areas
  • Hitchcock

Browse all communities in Texas

99308 billing questions

How do I choose between this code and 99309?

Use 99308 for low MDM or at least 20 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes; prescription drug management alone does not establish moderate MDM.

Can a nurse practitioner bill this visit?

Yes. Nurse practitioners and physician assistants may report subsequent nursing facility visits under their own NPI, subject to Medicare and state scope-of-practice requirements.

What time counts toward the 20 minutes?

Count the reporting practitioner's qualifying work on the encounter date, such as reviewing records, examining the resident, speaking with nursing staff or family, entering orders, and documenting. Exclude facility staff time and time spent on separately reported services.

Which place of service do I use?

Use POS 31 for a skilled nursing facility and POS 32 for a nursing facility. Medicare uses the facility rate for POS 31 and the nonfacility rate for POS 32.

Can I bill this on the day the resident is discharged from the facility?

When the practitioner performs discharge-day management, report 99315 or 99316 for that work rather than 99308. Select the discharge code based on the time spent on discharge management.

Can prolonged service time be added to this level?

No. Medicare's prolonged nursing facility E/M service for subsequent care pairs with 99310 when its time requirements are met, rather than with 99308.

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 99308PPRRVU2026_Oct_nonQPP.csv, line 13,049 (RVU26D)
Geographic factors for Galveston, TXGPCI2026.csv, line 101 (RVU26D)

Open CMS sourceHow we calculate rates

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