CPT code 99309: Nursing facility visit, subsequent, moderate MDM or 30 minutes2026 Medicare rate & RVUs in Alabama
Report a follow-up visit for a skilled nursing or nursing facility resident when the practitioner performs moderate medical decision making or spends at least 30 minutes.
In Alabama, Medicare pays $106.82 for 99309 in the office and $92.79 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 99309 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 99309 covers
This follow-up visit addresses a resident in a skilled nursing facility or nursing facility. A typical moderate-MDM encounter involves worsening heart failure requiring a diuretic change, or management of two stable chronic conditions with prescription medications. Attending physicians, nurse practitioners, and physician assistants perform these visits during post-acute or long-term care rounds. The visit may include assessing changes in condition, reviewing facility records, discussing care with nursing staff, and updating treatment orders.
Select the level by medical decision making (MDM) or the reporting practitioner's total time on the encounter date. Time-based selection requires at least 30 minutes and can include chart review, discussions with nurses or family, orders, and documentation; exclude staff time and time spent on separately reported services. For MDM-based selection, at least two of three elements must reach the moderate level: problems addressed, data reviewed or ordered, and management risk. Document the clinical changes, treatment decisions, or time supporting the chosen level. Report the correct place of service: skilled nursing facility (POS 31) uses facility practice expense inputs, while nursing facility (POS 32) uses nonfacility inputs.
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 Alabama compares for 99309
Across 109 of 109 payment localities, the office rate for 99309 runs from $105.85 in Arkansas to $147.50 in Alaska. Alabama pays $106.82. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Alabama · this page$106.82
- Los Angeles, CA · California$124.00+$17.18
- Washington, DC area · District of Columbia$126.70+$19.88
- Miami, FL · Florida$123.59+$16.77
- Chicago, IL · Illinois$121.30+$14.48
- Manhattan, NY · New York$128.82+$22.00
- Alaska · Alaska$147.50+$40.68
Other areas in Alabama first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| ArkansasArkansas | $105.85 | $92.07 |
| ArizonaArizona | $112.47 | $96.94 |
| Bakersfield, CACalifornia | $118.35 | $100.78 |
| Chico, CACalifornia | $117.88 | $100.31 |
| El Centro, CACalifornia | $117.90 | $100.33 |
| Fresno, CACalifornia | $117.88 | $100.31 |
| Hanford, CACalifornia | $117.88 | $100.31 |
| Madera, CACalifornia | $117.88 | $100.31 |
| Merced, CACalifornia | $117.88 | $100.31 |
| Modesto, CACalifornia | $117.88 | $100.31 |
| Napa, CACalifornia | $130.86 | $109.73 |
| Oxnard, CACalifornia | $122.93 | $103.98 |
| Redding, CACalifornia | $117.88 | $100.31 |
| Rest of CaliforniaCalifornia | $117.88 | $100.31 |
| Riverside, CACalifornia | $119.42 | $101.85 |
| Sacramento, CACalifornia | $122.16 | $103.52 |
| Salinas, CACalifornia | $121.66 | $103.08 |
| San Diego, CACalifornia | $123.32 | $104.14 |
| Marin County, CACalifornia | $136.89 | $114.28 |
| San Francisco, CACalifornia | $136.73 | $114.12 |
| San Benito County, CACalifornia | $139.68 | $116.56 |
| Santa Clara County, CACalifornia | $139.03 | $115.91 |
| San Luis Obispo, CACalifornia | $119.85 | $101.59 |
| Santa Cruz, CACalifornia | $123.58 | $104.10 |
| Santa Maria, CACalifornia | $121.79 | $103.09 |
| Santa Rosa, CACalifornia | $124.75 | $105.06 |
| Stockton, CACalifornia | $117.88 | $100.31 |
| Vallejo, CACalifornia | $130.63 | $109.50 |
| Visalia, CACalifornia | $117.88 | $100.31 |
| Yuba City, CACalifornia | $117.88 | $100.31 |
| ColoradoColorado | $117.24 | $100.18 |
| ConnecticutConnecticut | $120.35 | $103.09 |
| DelawareDelaware | $113.86 | $98.02 |
| Fort Lauderdale, FLFlorida | $118.94 | $102.70 |
| Rest of FloridaFlorida | $114.90 | $99.58 |
| Atlanta, GAGeorgia | $116.43 | $100.14 |
| Rest of GeorgiaGeorgia | $110.52 | $96.22 |
| Hawaii, Guam, HIHawaii | $118.87 | $100.64 |
| IowaIowa | $107.86 | $93.19 |
| IdahoIdaho | $108.44 | $93.69 |
| East St. Louis, ILIllinois | $115.65 | $100.90 |
| Rest of IllinoisIllinois | $113.22 | $98.58 |
| Suburban Chicago, ILIllinois | $119.86 | $103.39 |
| IndianaIndiana | $108.82 | $93.96 |
| KansasKansas | $107.85 | $93.36 |
| KentuckyKentucky | $109.09 | $94.84 |
| New Orleans, LALouisiana | $112.50 | $97.41 |
| Rest of LouisianaLouisiana | $109.11 | $94.92 |
| Metropolitan Boston, MAMassachusetts | $125.56 | $106.41 |
| Rest of MassachusettsMassachusetts | $117.07 | $100.18 |
| Baltimore area, MDMaryland | $120.04 | $102.84 |
| Rest of MarylandMaryland | $115.37 | $99.15 |
| Rest of MaineMaine | $109.14 | $94.39 |
| Southern Maine, MEMaine | $112.43 | $96.54 |
| Detroit, MIMichigan | $116.17 | $100.70 |
| Rest of MichiganMichigan | $111.19 | $96.55 |
| MinnesotaMinnesota | $112.60 | $96.10 |
| Metropolitan Kansas City, MOMissouri | $111.67 | $96.61 |
| Metropolitan St. Louis, MOMissouri | $112.38 | $97.12 |
| Rest of MissouriMissouri | $108.13 | $94.31 |
| MississippiMississippi | $106.98 | $93.18 |
| MontanaMontana | $114.56 | $98.52 |
| North CarolinaNorth Carolina | $109.81 | $94.85 |
| North DakotaNorth Dakota | $111.79 | $95.76 |
| NebraskaNebraska | $108.13 | $93.34 |
| New HampshireNew Hampshire | $115.86 | $99.17 |
| Northern New JerseyNew Jersey | $126.24 | $107.65 |
| Rest of New JerseyNew Jersey | $121.79 | $104.29 |
| New MexicoNew Mexico | $111.71 | $97.01 |
| NevadaNevada | $113.83 | $97.78 |
| NYC suburbs and Long Island, NYNew York | $131.33 | $112.26 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $122.78 | $105.22 |
| Queens, NYNew York | $129.06 | $110.11 |
| Rest of New YorkNew York | $110.89 | $95.66 |
| OhioOhio | $110.62 | $95.98 |
| OklahomaOklahoma | $108.63 | $94.31 |
| Portland, OROregon | $119.47 | $101.66 |
| Rest of OregonOregon | $112.99 | $97.02 |
| Metropolitan Philadelphia, PAPennsylvania | $118.50 | $101.81 |
| Rest of PennsylvaniaPennsylvania | $110.56 | $95.84 |
| Puerto RicoPuerto Rico | $115.00 | $98.79 |
| Rhode IslandRhode Island | $116.79 | $100.23 |
| South CarolinaSouth Carolina | $110.39 | $95.57 |
| South DakotaSouth Dakota | $111.46 | $95.43 |
| TennesseeTennessee | $108.24 | $93.66 |
| Austin, TXTexas | $116.81 | $99.85 |
| Beaumont, TXTexas | $110.11 | $95.53 |
| Brazoria, TXTexas | $113.64 | $97.75 |
| Dallas, TXTexas | $114.30 | $98.33 |
| Fort Worth, TXTexas | $113.90 | $98.09 |
| Galveston, TXTexas | $113.95 | $98.03 |
| Houston, TXTexas | $116.52 | $100.60 |
| Rest of TexasTexas | $111.78 | $96.56 |
| UtahUtah | $111.34 | $96.27 |
| VirginiaVirginia | $112.41 | $96.65 |
| Virgin Islands, VIUnited States Virgin Islands | $115.00 | $98.79 |
| VermontVermont | $111.80 | $95.93 |
| Rest of WashingtonWashington | $116.71 | $99.82 |
| King County, WAWashington | $127.30 | $107.63 |
| WisconsinWisconsin | $109.41 | $94.05 |
| West VirginiaWest Virginia | $110.59 | $96.65 |
| WyomingWyoming | $113.35 | $97.32 |
99309 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.
$105.85
$147.50
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $147.50 | 1 |
| AL | $106.82 | 1 |
| AR | $105.85 | 1 |
| AZ | $112.47 | 1 |
| CA | $117.88–$139.68 | 29 |
| CO | $117.24 | 1 |
| CT | $120.35 | 1 |
| DC | $126.70 | 1 |
| DE | $113.86 | 1 |
| FL | $114.90–$123.59 | 3 |
| GA | $110.52–$116.43 | 2 |
| GU | $118.87 | 1 |
| HI | $118.87 | 1 |
| IA | $107.86 | 1 |
| ID | $108.44 | 1 |
| IL | $113.22–$121.30 | 4 |
| IN | $108.82 | 1 |
| KS | $107.85 | 1 |
| KY | $109.09 | 1 |
| LA | $109.11–$112.50 | 2 |
| MA | $117.07–$125.56 | 2 |
| MD | $115.37–$126.70 | 3 |
| ME | $109.14–$112.43 | 2 |
| MI | $111.19–$116.17 | 2 |
| MN | $112.60 | 1 |
| MO | $108.13–$112.38 | 3 |
| MS | $106.98 | 1 |
| MT | $114.56 | 1 |
| NC | $109.81 | 1 |
| ND | $111.79 | 1 |
| NE | $108.13 | 1 |
| NH | $115.86 | 1 |
| NJ | $121.79–$126.24 | 2 |
| NM | $111.71 | 1 |
| NV | $113.83 | 1 |
| NY | $110.89–$131.33 | 5 |
| OH | $110.62 | 1 |
| OK | $108.63 | 1 |
| OR | $112.99–$119.47 | 2 |
| PA | $110.56–$118.50 | 2 |
| PR | $115.00 | 1 |
| RI | $116.79 | 1 |
| SC | $110.39 | 1 |
| SD | $111.46 | 1 |
| TN | $108.24 | 1 |
| TX | $110.11–$116.81 | 8 |
| UT | $111.34 | 1 |
| VA | $112.41–$126.70 | 2 |
| VI | $115.00 | 1 |
| VT | $111.80 | 1 |
| WA | $116.71–$127.30 | 2 |
| WI | $109.41 | 1 |
| WV | $110.59 | 1 |
| WY | $113.35 | 1 |
How the 99309 rate is calculated
Each of 99309’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 · 99309
RVUs × geographic indexes × conversion factor
Work1.92
1.92 RVUs× 1.000 GPCI
Practice expense1.37
1.37 RVUs× 1.000 GPCI
Malpractice0.14
0.14 RVUs× 1.000 GPCI
Adjusted RVUs
3.4300
Conversion factor
$33.4009
Medicare rate
$114.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Alabama inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
13,050
- Code
- 99309
- Physician work
- 1.92
- Practice expense
- 1.37
- Malpractice
- 0.14
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.92 | × 1.000 | 1.9200 |
| Practice expense | 1.37 | × 0.875 | 1.1987 |
| Malpractice | 0.14 | × 0.566 | 0.0792 |
| Total RVUs | 3.1980 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Alabama$106.82
Office: (1.92 × 1 + 1.37 × 0.875 + 0.14 × 0.566) × $33.4009 = $106.82
Facility: (1.92 × 1 + 0.89 × 0.875 + 0.14 × 0.566) × $33.4009 = $92.79
Payment rules and modifiers for 99309
99309 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 · 99309
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$114.57
- Non-facility (office)
- $114.57
- Facility
- $98.53
Higher because the practice carries its own overhead.
How 99309 has changed in Alabama
99309 · Office / nonfacility
$106.82
Effective 2026-10-01
The base rate is $9.41 higher than on 2025-10-01, moving from $97.41 to $106.82 (9.7%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$97.41changed to$106.82
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 1.17 changed to 1.37
- Malpractice RVU 0.13 changed to 0.14
- Practice expense GPCI 0.869 changed to 0.875
- Malpractice GPCI 0.575 changed to 0.566
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$99.96changed to$97.41
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.16 changed to 1.17
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$98.32changed to$99.96
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$101.13changed to$98.32
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 1.11 changed to 1.16
- Malpractice RVU 0.12 changed to 0.13
- Practice expense GPCI 0.878 changed to 0.869
- Malpractice GPCI 0.748 changed to 0.575
January 1, 2023
RVU23A
$86.64changed to$101.13
- Conversion factor 34.6062 changed to 33.8872
- Work RVU 1.55 changed to 1.92
- Practice expense RVU 0.97 changed to 1.11
- Malpractice RVU 0.10 changed to 0.12
- Practice expense GPCI 0.888 changed to 0.878
- Malpractice GPCI 0.921 changed to 0.748
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$87.04changed to$86.64
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 0.96 changed to 0.97
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$88.07changed to$87.04
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 0.93 changed to 0.96
- Malpractice RVU 0.09 changed to 0.10
- Practice expense GPCI 0.889 changed to 0.888
- Malpractice GPCI 0.707 changed to 0.921
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$87.32changed to$88.07
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 0.92 changed to 0.93
- Malpractice RVU 0.11 changed to 0.09
- Practice expense GPCI 0.890 changed to 0.889
- Malpractice GPCI 0.492 changed to 0.707
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$87.54changed to$87.32
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 0.93 changed to 0.92
Held through RVU19B, RVU19C, RVU19D.
April 1, 2018
RVU18B
No ratechanged to$87.54
Held through RVU18C, RVU18D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $106.82 | $92.79 | RVU26D |
| 2026-07-01 | $106.82 | $92.79 | RVU26C |
| 2026-04-01 | $106.82 | $92.79 | RVU26B |
| 2026-01-01 | $106.82 | $92.79 | RVU26A |
| 2025-10-01 | $97.41 | $97.41 | RVU25D |
| 2025-07-01 | $97.41 | $97.41 | RVU25C |
| 2025-04-01 | $97.41 | $97.41 | RVU25B |
| 2025-01-01 | $97.41 | $97.41 | RVU25A |
| 2024-10-01 | $99.96 | $99.96 | RVU24D |
| 2024-07-01 | $99.96 | $99.96 | RVU24C |
| 2024-04-01 | $99.96 | $99.96 | RVU24B |
| 2024-03-09 | $99.96 | $99.96 | RVU24AR |
| 2024-01-01 | $98.32 | $98.32 | RVU24A |
| 2023-10-01 | $101.13 | $101.13 | RVU23D |
| 2023-07-01 | $101.13 | $101.13 | RVU23C |
| 2023-04-01 | $101.13 | $101.13 | RVU23B |
| 2023-01-01 | $101.13 | $101.13 | RVU23A |
| 2022-10-01 | $86.64 | $86.64 | RVU22D |
| 2022-07-01 | $86.64 | $86.64 | RVU22C |
| 2022-04-01 | $86.64 | $86.64 | RVU22B |
| 2022-01-01 | $86.64 | $86.64 | RVU22A |
| 2021-10-01 | $87.04 | $87.04 | RVU21D |
| 2021-07-01 | $87.04 | $87.04 | RVU21C |
| 2021-04-01 | $87.04 | $87.04 | RVU21B |
| 2021-01-01 | $87.04 | $87.04 | RVU21A |
| 2020-10-01 | $88.07 | $88.07 | RVU20D |
| 2020-07-01 | $88.07 | $88.07 | RVU20C |
| 2020-04-01 | $88.07 | $88.07 | RVU20B |
| 2020-01-01 | $88.07 | $88.07 | RVU20A |
| 2019-10-01 | $87.32 | $87.32 | RVU19D |
| 2019-07-01 | $87.32 | $87.32 | RVU19C |
| 2019-04-01 | $87.32 | $87.32 | RVU19B |
| 2019-01-01 | $87.32 | $87.32 | RVU19A |
| 2018-10-01 | $87.54 | $87.54 | RVU18D |
| 2018-07-01 | $87.54 | $87.54 | RVU18C |
| 2018-04-01 | $87.54 | $87.54 | RVU18B |
| 2018-01-01 | Rate data unavailable | Rate data unavailable | RVU18AR1 |
| 2017-10-01 | Rate data unavailable | Rate data unavailable | RVU17D |
| 2017-07-01 | Rate data unavailable | Rate data unavailable | RVU17C |
| 2017-04-01 | Rate data unavailable | Rate data unavailable | RVU17B |
| 2017-01-01 | Rate data unavailable | Rate data unavailable | RVU17A |
| 2016-10-01 | Rate data unavailable | Rate data unavailable | RVU16D |
| 2016-07-01 | Rate data unavailable | Rate data unavailable | RVU16C |
| 2016-04-01 | Rate data unavailable | Rate data unavailable | RVU16B |
| 2016-01-01 | Rate data unavailable | Rate data unavailable | RVU16A |
| 2015-10-01 | Rate data unavailable | Rate data unavailable | RVU15D |
| 2015-07-01 | Rate data unavailable | Rate data unavailable | RVU15C |
| 2015-04-01 | Rate data unavailable | Rate data unavailable | RVU15B |
| 2015-01-01 | Rate data unavailable | Rate data unavailable | RVU15A |
| 2014-10-01 | Rate data unavailable | Rate data unavailable | RVU14D |
| 2014-07-01 | Rate data unavailable | Rate data unavailable | RVU14C |
| 2014-04-01 | Rate data unavailable | Rate data unavailable | RVU14B |
| 2014-01-01 | Rate data unavailable | Rate data unavailable | RVU14A |
| 2013-10-01 | Rate data unavailable | Rate data unavailable | RVU13D |
| 2013-07-01 | Rate data unavailable | Rate data unavailable | RVU13C |
| 2013-04-01 | Rate data unavailable | Rate data unavailable | RVU13B |
| 2013-01-01 | Rate data unavailable | Rate data unavailable | RVU13AR |
Where the Alabama rate applies
Alabama is a Medicare payment area, not a city. Our Census mapping connects it to 595 cities and communities in Alabama. Some span more than one payment area; confirm with the service ZIP.
- Abanda
- Abbeville
- Adamsville
- Addison
- Akron
- Alabaster
- Albertville
- Alexander City
99309 billing questions
When does a visit qualify as 99309 instead of 99308?
Choose 99309 when at least two MDM elements reach the moderate level or the reporting practitioner spends at least 30 minutes on the encounter date. Choose 99308 for low MDM or when at least 20 minutes supports time-based selection but the 99309 threshold is not met.
What counts toward the 30 minutes?
Count the reporting physician's or qualified health care professional's time on the encounter date, including the visit, record review, discussions with nurses or family, orders, and documentation. Exclude facility staff time, time on other dates, and time spent on separately reported services.
Can 99309 be reported for an assisted living resident?
No. Assisted living is a home or residence setting; select the appropriate home or residence E/M code based on the patient's status, MDM, or time. Nursing facility visit codes are for skilled nursing facilities and nursing facilities.
Can 99309 be reported on the same day as the discharge visit?
The practitioner reporting nursing facility discharge management uses 99315 or 99316 for work performed on the discharge date rather than also reporting a subsequent nursing facility visit for that work.
Is 99309 used for the first visit after a resident's readmission?
If the practitioner performs the initial nursing facility assessment for the readmission, select an initial visit code from 99304–99306. Use 99307–99310 for subsequent visits.
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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