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

Report nursing facility discharge management when a physician or qualified health professional provides discharge-day evaluation and coordination requiring more than 30 minutes.

CMS RVU26DEffective Oct 1, 2026One payment locality378K Medicare services in 2024

In Puerto Rico, Medicare pays $138.73 for 99316 in the office and $117.80 when it’s performed in a hospital or facility.

$138.73Office (non-facility)
$117.80Hospital or facility
+0.3%vs the national office rate ($138.28)

Check a contract rate as a % of Medicare · 99316 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 99316 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 99316 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 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.

How Puerto Rico compares for 99316

Across 109 of 109 payment localities, the office rate for 99316 runs from $128.60 in Arkansas to $180.67 in Alaska. Puerto Rico pays $138.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

99316 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$138.73
  2. Los Angeles, CA · California$148.78+$10.05
  3. Washington, DC area · District of Columbia$152.17+$13.44
  4. Miami, FL · Florida$148.97+$10.24
  5. Chicago, IL · Illinois$146.46+$7.73
  6. Manhattan, NY · New York$154.91+$16.18
  7. Alaska · Alaska$180.67+$41.94

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

Every other payment area

99316 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$129.68$111.56
ArkansasArkansas$128.60$110.81
ArizonaArizona$135.94$115.87
Bakersfield, CACalifornia$142.36$119.66
Chico, CACalifornia$141.78$119.08
El Centro, CACalifornia$141.81$119.11
Fresno, CACalifornia$141.78$119.08
Hanford, CACalifornia$141.78$119.08

99316 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.

$128.60

$180.67

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

View every state and territory as a table
99316 office rate range by state
State / territoryOffice rate rangeLocalities
AK$180.671
AL$129.681
AR$128.601
AZ$135.941
CA$141.78–$166.5329
CO$141.181
CT$144.921
DC$152.171
DE$137.531
FL$138.98–$148.973
GA$134.07–$140.462
GU$142.621
HI$142.621
IA$130.681
ID$131.361
IL$137.20–$146.464
IN$131.781
KS$130.751
KY$132.351
LA$132.39–$136.162
MA$141.07–$150.602
MD$139.24–$152.173
ME$132.21–$135.742
MI$134.74–$140.462
MN$135.711
MO$131.36–$135.933
MS$129.971
MT$138.271
NC$132.941
ND$134.911
NE$130.971
NH$139.581
NJ$146.69–$151.782
NM$135.351
NV$137.381
NY$134.14–$157.775
OH$134.051
OK$131.761
OR$136.40–$143.612
PA$133.94–$142.892
PR$138.731
RI$140.871
SC$133.701
SD$134.511
TN$131.181
TX$133.46–$140.748
UT$134.751
VA$135.78–$152.172
VI$138.731
VT$134.981
WA$140.61–$152.562
WI$132.291
WV$134.291
WY$136.801

See 99316 in every payment locality

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.

How the rate is built · 99316

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.50

2.50 RVUs× 1.000 GPCI

Practice expense1.47

1.47 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

4.1400

Conversion factor

$33.4009

Medicare rate

$138.28

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

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,053

Code
99316
Physician work
2.50
Practice expense
1.47
Malpractice
0.17

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 99316 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.50× 1.0002.5000
Practice expense1.47× 1.0111.4862
Malpractice0.17× 0.9850.1675
Total RVUs4.1536
Conversion factor× 33.4009

Office rate, Puerto Rico$138.73

Office: (2.5 × 1 + 1.47 × 1.011 + 0.17 × 0.985) × $33.4009 = $138.73

Facility: (2.5 × 1 + 0.85 × 1.011 + 0.17 × 0.985) × $33.4009 = $117.80

Open 99316 in the RVU calculator

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.

Place of service · 99316

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$138.28

Non-facility (office)
$138.28
Facility
$117.57

Higher because the practice carries its own overhead.

How 99316 has changed in Puerto Rico

99316 · Office / nonfacility

$138.73

Effective 2026-10-01

The base rate is $12.72 higher than on 2025-10-01, moving from $126.01 to $138.73 (10.1%).

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

    $126.01changed to$138.73

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.23 changed to 1.47
    • Malpractice RVU 0.16 changed to 0.17
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $130.01changed to$126.01

    • Conversion factor 33.2875 changed to 32.3465
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $127.88changed to$130.01

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $131.71changed to$127.88

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.20 changed to 1.23
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $131.48changed to$131.71

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $103.69changed to$131.48

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.90 changed to 2.50
    • Practice expense RVU 0.98 changed to 1.20
    • Malpractice RVU 0.11 changed to 0.18
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $105.24changed to$103.69

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.13 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $107.42changed to$105.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.96 changed to 0.98
    • Malpractice RVU 0.11 changed to 0.13
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $107.59changed to$107.42

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.95 changed to 0.96
    • Malpractice RVU 0.13 changed to 0.11
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $108.20changed to$107.59

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.97 changed to 0.95

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $100.68changed to$108.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 0.96 changed to 0.97
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $93.37changed to$100.68

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.95 changed to 0.96
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $93.50changed to$93.37

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.11 changed to 0.13

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $93.03changed to$93.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $92.34changed to$93.03

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.94 changed to 0.95
    • Malpractice RVU 0.10 changed to 0.11
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $88.79changed to$92.34

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.01 changed to 0.94
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $88.79

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$138.73$117.80RVU26D
2026-07-01$138.73$117.80RVU26C
2026-04-01$138.73$117.80RVU26B
2026-01-01$138.73$117.80RVU26A
2025-10-01$126.01$126.01RVU25D
2025-07-01$126.01$126.01RVU25C
2025-04-01$126.01$126.01RVU25B
2025-01-01$126.01$126.01RVU25A
2024-10-01$130.01$130.01RVU24D
2024-07-01$130.01$130.01RVU24C
2024-04-01$130.01$130.01RVU24B
2024-03-09$130.01$130.01RVU24AR
2024-01-01$127.88$127.88RVU24A
2023-10-01$131.71$131.71RVU23D
2023-07-01$131.48$131.48RVU23C
2023-04-01$131.48$131.48RVU23B
2023-01-01$131.48$131.48RVU23A
2022-10-01$103.69$103.69RVU22D
2022-07-01$103.69$103.69RVU22C
2022-04-01$103.69$103.69RVU22B
2022-01-01$103.69$103.69RVU22A
2021-10-01$105.24$105.24RVU21D
2021-07-01$105.24$105.24RVU21C
2021-04-01$105.24$105.24RVU21B
2021-01-01$105.24$105.24RVU21A
2020-10-01$107.42$107.42RVU20D
2020-07-01$107.42$107.42RVU20C
2020-04-01$107.42$107.42RVU20B
2020-01-01$107.42$107.42RVU20A
2019-10-01$107.59$107.59RVU19D
2019-07-01$107.59$107.59RVU19C
2019-04-01$107.59$107.59RVU19B
2019-01-01$107.59$107.59RVU19A
2018-10-01$108.20$108.20RVU18D
2018-07-01$108.20$108.20RVU18C
2018-04-01$108.20$108.20RVU18B
2018-01-01$108.20$108.20RVU18AR1
2017-10-01$100.68$100.68RVU17D
2017-07-01$100.68$100.68RVU17C
2017-04-01$100.68$100.68RVU17B
2017-01-01$100.68$100.68RVU17A
2016-10-01$93.37$93.37RVU16D
2016-07-01$93.37$93.37RVU16C
2016-04-01$93.37$93.37RVU16B
2016-01-01$93.37$93.37RVU16A
2015-10-01$93.50$93.50RVU15D
2015-07-01$93.50$93.50RVU15C
2015-04-01$93.03$93.03RVU15B
2015-01-01$93.03$93.03RVU15A
2014-10-01$92.34$92.34RVU14D
2014-07-01$92.34$92.34RVU14C
2014-04-01$92.34$92.34RVU14B
2014-01-01$92.34$92.34RVU14A
2013-10-01$88.79$88.79RVU13D
2013-07-01$88.79$88.79RVU13C
2013-04-01$88.79$88.79RVU13B
2013-01-01$88.79$88.79RVU13AR

Price 99316 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

99316 billing questions

How does 99316 differ from 99315?

The distinction is total discharge-management time: 99316 is for more than 30 minutes, while 99315 is for 30 minutes or less. Document the time supporting the selected code.

What work can count toward the discharge-management service?

The service may include the final examination, discharge-plan discussion and instructions, preparing records or prescriptions, arranging referrals, and communicating with other professionals about the transition.

What time and documentation should the record show?

Record the discharge date, total time spent on discharge management, and the activities performed. The documented total must exceed 30 minutes for 99316.

Is a routine nursing facility follow-up visit the same service?

No. Discharge management addresses the work of preparing a patient to leave the facility; subsequent nursing facility care codes describe follow-up care while the patient remains in the facility.

Can post-discharge home care be reported as 99316?

No. Code 99316 describes nursing facility discharge-day management, not a later home or residence visit. Select a home or residence E/M code when a separate visit occurs after discharge.

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 99316PPRRVU2026_Oct_nonQPP.csv, line 13,053 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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