CPT code 99316: Discharge management, more than 30 minutes2026 Medicare rate & RVUs

Medicare pays $138.28 for 99316 nationally in the office and $117.57 in a hospital or facility. Local office rates run $128.60–$180.67.

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

What 99316 covers

Code 99316 describes discharge-day management for a patient leaving a nursing facility. A physician or other qualified health professional may perform the service before discharge to home, assisted living, or another care setting. The work can include a final examination, discussion of the discharge plan and instructions with the patient or caregiver, preparation of discharge records and prescriptions, arranging referrals, and communicating with other professionals involved in the transition.

Select this code when the total time spent on discharge management is more than 30 minutes; use 99315 when the service takes 30 minutes or less. Document the discharge date, total time, and the management activities performed. The activities involved in completing the discharge are represented by the discharge-management service rather than itemized as separate discharge-management codes. CMS assigns work, practice-expense, and malpractice relative value units to the service.

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 99316 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99316 rates by state

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

How the 99316 rate is calculated

Each of 99316’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 99316

99316 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.

99316 compared with similar codes

How to choose

99315Discharge management30 minutes or less

Both codes describe nursing facility discharge-day management. Choose 99316 when total time is more than 30 minutes; choose 99315 for 30 minutes or less.

99309Nursing facility visitSubsequent, moderate MDM or 30 minutes

99309 describes subsequent nursing facility care, not discharge management. Use it for a qualifying facility follow-up encounter rather than work preparing the patient to leave.

99348Home visitEstablished patient, low MDM or 30 minutes

99348 is an established-patient home or residence visit. It may describe a separate post-discharge visit, whereas 99316 covers nursing facility discharge-day work.

Codes related to 99316

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

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