CPT code 99310: Nursing facility visit, subsequent visit, high MDM2026 Medicare rate & RVUs in North Dakota

Follow-up nursing facility or skilled nursing facility visit for a resident whose care requires high-complexity medical decision making or at least 45 minutes of practitioner time.

CMS RVU26DEffective Oct 1, 2026One payment locality2.2M Medicare services in 2024

In North Dakota, Medicare pays $159.16 for 99310 in the office and $136.12 when it’s performed in a hospital or facility.

$159.16Office (non-facility)
$136.12Hospital or facility
−2.6%vs the national office rate ($163.33)

Check a contract rate as a % of Medicare · 99310 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 99310 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Dakota
  2. What 99310 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 99310 covers

This is the highest level in the subsequent nursing facility E/M series. It covers a follow-up visit to a skilled nursing facility or long-term nursing facility resident after the initial evaluation. A practitioner might assess suspected sepsis, new respiratory failure, or a severe heart failure or COPD exacerbation and decide whether hospital transfer or a major change in treatment is needed. Attending physicians, geriatricians, nurse practitioners, and physician assistants commonly provide these visits during facility rounds.

Select 99310 when medical decision making is high or the reporting practitioner's qualifying time on the date of service reaches 45 minutes. High MDM requires two of three elements—problems, data, and management risk—at the high level; a hospitalization decision alone does not establish the overall level. Time may include examining the resident, reviewing records, coordinating with facility staff, and documenting, but excludes staff time and work counted toward another reported service. Document the supporting MDM elements or total qualifying time. If the visit is selected by time and Medicare's prolonged-service threshold is met, G0317 may be reported for eligible additional 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 North Dakota compares for 99310

Across 109 of 109 payment localities, the office rate for 99310 runs from $151.07 in Arkansas to $211.02 in Alaska. North Dakota pays $159.16. The RVUs are the same everywhere; the geographic indexes change the dollars.

99310 in North Dakota vs other payment areas
  1. North Dakota · this page$159.16
  2. Los Angeles, CA · California$176.30+$17.14
  3. Washington, DC area · District of Columbia$180.35+$21.19
  4. Miami, FL · Florida$176.63+$17.47
  5. Chicago, IL · Illinois$173.38+$14.22
  6. Manhattan, NY · New York$183.60+$24.44
  7. Alaska · Alaska$211.02+$51.86

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

Every other payment area

99310 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$152.44$132.27
ArkansasArkansas$151.07$131.28
ArizonaArizona$160.37$138.04
Bakersfield, CACalifornia$168.39$143.13
Chico, CACalifornia$167.69$142.43
El Centro, CACalifornia$167.73$142.47
Fresno, CACalifornia$167.69$142.43
Hanford, CACalifornia$167.69$142.43

99310 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.

$151.07

$211.02

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

View every state and territory as a table
99310 office rate range by state
State / territoryOffice rate rangeLocalities
AK$211.021
AL$152.441
AR$151.071
AZ$160.371
CA$167.69–$198.1229
CO$166.941
CT$171.511
DC$180.351
DE$162.341
FL$164.10–$176.633
GA$157.90–$166.032
GU$168.981
HI$168.981
IA$153.761
ID$154.611
IL$161.82–$173.384
IN$155.141
KS$153.821
KY$155.761
LA$155.81–$160.582
MA$166.73–$178.582
MD$164.44–$180.353
ME$155.66–$160.182
MI$158.77–$165.942
MN$160.211
MO$154.48–$160.333
MS$152.771
MT$163.321
NC$156.591
ND$159.161
NE$154.131
NH$165.031
NJ$173.53–$179.752
NM$159.531
NV$162.221
NY$158.11–$187.205
OH$157.921
OK$155.051
OR$161.00–$170.002
PA$157.80–$168.942
PR$163.921
RI$166.421
SC$157.511
SD$158.671
TN$154.371
TX$157.18–$166.368
UT$158.851
VA$160.20–$180.352
VI$163.921
VT$159.241
WA$166.20–$180.982
WI$155.841
WV$158.131
WY$161.511

See 99310 in every payment locality

How the 99310 rate is calculated

Each of 99310’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 · 99310

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.80

2.80 RVUs× 1.000 GPCI

Practice expense1.88

1.88 RVUs× 1.000 GPCI

Malpractice0.21

0.21 RVUs× 1.000 GPCI

Adjusted RVUs

4.8900

Conversion factor

$33.4009

Medicare rate

$163.33

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

The exact North Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,051

Code
99310
Physician work
2.80
Practice expense
1.88
Malpractice
0.21

GPCI2026.csv

84

Locality
North Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.406
Office calculation for 99310 in North Dakota
ComponentRVULocality factorAdjusted
Physician work2.80× 1.0002.8000
Practice expense1.88× 1.0001.8800
Malpractice0.21× 0.4060.0853
Total RVUs4.7653
Conversion factor× 33.4009

Office rate, North Dakota$159.16

Office: (2.8 × 1 + 1.88 × 1 + 0.21 × 0.406) × $33.4009 = $159.16

Facility: (2.8 × 1 + 1.19 × 1 + 0.21 × 0.406) × $33.4009 = $136.12

Open 99310 in the RVU calculator

Payment rules and modifiers for 99310

99310 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 · 99310

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$163.33

Non-facility (office)
$163.33
Facility
$140.28

Higher because the practice carries its own overhead.

How 99310 has changed in North Dakota

99310 · Office / nonfacility

$159.16

Effective 2026-10-01

The base rate is $13.81 higher than on 2025-10-01, moving from $145.35 to $159.16 (9.5%).

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

    $145.35changed to$159.16

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.59 changed to 1.88
    • Malpractice RVU 0.20 changed to 0.21
    • Malpractice GPCI 0.517 changed to 0.406

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $149.24changed to$145.35

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.58 changed to 1.59

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $146.81changed to$149.24

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $150.12changed to$146.81

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.54 changed to 1.58
    • Malpractice RVU 0.19 changed to 0.20
    • Malpractice GPCI 0.474 changed to 0.517
  5. January 1, 2023

    RVU23A

    $130.82changed to$150.12

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 2.35 changed to 2.80
    • Practice expense RVU 1.37 changed to 1.54
    • Malpractice RVU 0.14 changed to 0.19
    • Malpractice GPCI 0.431 changed to 0.474

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $132.06changed to$130.82

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.15 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $134.36changed to$132.06

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.31 changed to 1.37
    • Malpractice RVU 0.13 changed to 0.15
    • Malpractice GPCI 0.485 changed to 0.431

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $135.02changed to$134.36

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.16 changed to 0.13
    • Malpractice GPCI 0.540 changed to 0.485

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $135.95changed to$135.02

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.34 changed to 1.31

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $135.21changed to$135.95

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.33 changed to 1.34
    • Malpractice GPCI 0.547 changed to 0.540

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $134.22changed to$135.21

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.31 changed to 1.33
    • Malpractice GPCI 0.554 changed to 0.547

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $134.50changed to$134.22

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.15 changed to 0.16

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $133.83changed to$134.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $133.25changed to$133.83

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.30 changed to 1.31
    • Malpractice RVU 0.13 changed to 0.15
    • Malpractice GPCI 0.536 changed to 0.554

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $130.05changed to$133.25

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.40 changed to 1.30
    • Malpractice RVU 0.14 changed to 0.13
    • Malpractice GPCI 0.517 changed to 0.536

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $130.05

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$159.16$136.12RVU26D
2026-07-01$159.16$136.12RVU26C
2026-04-01$159.16$136.12RVU26B
2026-01-01$159.16$136.12RVU26A
2025-10-01$145.35$145.35RVU25D
2025-07-01$145.35$145.35RVU25C
2025-04-01$145.35$145.35RVU25B
2025-01-01$145.35$145.35RVU25A
2024-10-01$149.24$149.24RVU24D
2024-07-01$149.24$149.24RVU24C
2024-04-01$149.24$149.24RVU24B
2024-03-09$149.24$149.24RVU24AR
2024-01-01$146.81$146.81RVU24A
2023-10-01$150.12$150.12RVU23D
2023-07-01$150.12$150.12RVU23C
2023-04-01$150.12$150.12RVU23B
2023-01-01$150.12$150.12RVU23A
2022-10-01$130.82$130.82RVU22D
2022-07-01$130.82$130.82RVU22C
2022-04-01$130.82$130.82RVU22B
2022-01-01$130.82$130.82RVU22A
2021-10-01$132.06$132.06RVU21D
2021-07-01$132.06$132.06RVU21C
2021-04-01$132.06$132.06RVU21B
2021-01-01$132.06$132.06RVU21A
2020-10-01$134.36$134.36RVU20D
2020-07-01$134.36$134.36RVU20C
2020-04-01$134.36$134.36RVU20B
2020-01-01$134.36$134.36RVU20A
2019-10-01$135.02$135.02RVU19D
2019-07-01$135.02$135.02RVU19C
2019-04-01$135.02$135.02RVU19B
2019-01-01$135.02$135.02RVU19A
2018-10-01$135.95$135.95RVU18D
2018-07-01$135.95$135.95RVU18C
2018-04-01$135.95$135.95RVU18B
2018-01-01$135.95$135.95RVU18AR1
2017-10-01$135.21$135.21RVU17D
2017-07-01$135.21$135.21RVU17C
2017-04-01$135.21$135.21RVU17B
2017-01-01$135.21$135.21RVU17A
2016-10-01$134.22$134.22RVU16D
2016-07-01$134.22$134.22RVU16C
2016-04-01$134.22$134.22RVU16B
2016-01-01$134.22$134.22RVU16A
2015-10-01$134.50$134.50RVU15D
2015-07-01$134.50$134.50RVU15C
2015-04-01$133.83$133.83RVU15B
2015-01-01$133.83$133.83RVU15A
2014-10-01$133.25$133.25RVU14D
2014-07-01$133.25$133.25RVU14C
2014-04-01$133.25$133.25RVU14B
2014-01-01$133.25$133.25RVU14A
2013-10-01$130.05$130.05RVU13D
2013-07-01$130.05$130.05RVU13C
2013-04-01$130.05$130.05RVU13B
2013-01-01$130.05$130.05RVU13AR

Price 99310 for an earlier date of service

Where the North Dakota rate applies

North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Abercrombie
  • Adams
  • Alamo
  • Alexander
  • Alice
  • Almont
  • Alsen
  • Ambrose

Browse all communities in North Dakota

99310 billing questions

How do I decide between 99309 and 99310?

Use 99310 for high MDM or at least 45 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes when 99310's criteria are not met; a hospitalization decision can support high management risk but does not, by itself, establish high MDM.

Can 99310 be reported for a resident's first visit by our group?

Choose the code based on the service performed, not simply whether the resident is new to the group. Initial nursing facility codes 99304-99306 describe an initial evaluation; 99310 describes subsequent care.

What counts toward the 45 minutes?

Count the reporting practitioner's qualifying work on the date of service, such as examining the resident, reviewing records, coordinating care, ordering, and documenting. Exclude facility staff time and time spent on separately reported services.

How is prolonged time billed for Medicare with 99310?

When 99310 is selected by time and Medicare's threshold for prolonged nursing facility care is met, report G0317 for eligible additional 15-minute increments rather than CPT 99418. Document the total qualifying time.

Which place of service is used?

Use POS 31 for a skilled nursing facility stay and POS 32 for a nursing facility. Visits to assisted living residents fall under home or residence visit codes instead.

Can I bill 99310 and a discharge code for the same service?

No. When the service is nursing facility discharge management, report 99315 or 99316 according to the time spent on that service instead of 99310.

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 99310PPRRVU2026_Oct_nonQPP.csv, line 13,051 (RVU26D)
Geographic factors for North DakotaGPCI2026.csv, line 84 (RVU26D)

Open CMS sourceHow we calculate rates

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