CPT code 99341: Home visit, new patient, straightforward MDM2026 Medicare rate & RVUs in Massachusetts
Reports a new patient evaluation in a home or residence when the encounter supports straightforward medical decision making or at least 15 minutes of total time.
Medicare pays $50.12–$53.11 for 99341 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 99341 covers
A physician or other qualified health professional reports this evaluation and management service for a new patient seen in a private home or another residence, such as an assisted living facility or group home. The encounter addresses the patient's health needs at that location; the service is not an initial nursing facility visit. The clinician performs a medically appropriate history and/or examination as indicated by the problem.
Select this code when medical decision making is straightforward, or when using time for code selection, the clinician documents at least 15 minutes of qualifying total time on the encounter date. The patient must meet the new-patient definition: no professional service in the preceding three years from the clinician or another clinician of the same specialty and subspecialty in the same group. The record should support the residence setting, new-patient status, assessment and plan, and the MDM or time basis for the level.
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 99341 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $53.11 | Unavailable |
| Rest of Massachusetts | $50.12 | Unavailable |
How the 99341 rate is calculated
Each of 99341’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 · 99341
RVUs × geographic indexes × conversion factor
Work1.00
1.00 RVUs× 1.000 GPCI
Practice expense0.43
0.43 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.4700
Conversion factor
$33.4009
Medicare rate
$49.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99341
99341 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 · 99341
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$49.10
Higher because the practice carries its own overhead.
99341 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99342Home visitNew patient, low MDM
- Both are new-patient home or residence visits. 99341 is for straightforward MDM or its lower time level; 99342 is for low MDM or its higher time threshold.
- 99347Home visitEstablished patient, straightforward MDM
- 99347 is for an established patient in a home or residence. Use 99341 only when the patient meets the new-patient definition.
- 99305Nursing facility visitInitial visit, moderate MDM
- 99305 is initial nursing facility care with moderate MDM, not an evaluation in a patient's home or residence.
99341 billing questions
When should 99341 be chosen instead of 99342?
Use 99341 for straightforward medical decision making or at least 15 minutes when selecting by time. Choose 99342 when the encounter supports low medical decision making or its applicable time threshold.
What makes the patient new for this code?
The patient has not received a professional service in the preceding three years from the reporting clinician or another clinician of the same specialty and subspecialty in the same group.
Can the code be selected by time rather than medical decision making?
Yes. Document at least 15 minutes of qualifying total time on the date of the encounter when using time to select 99341.
Is 99341 used for an initial nursing facility visit?
No. It is for an evaluation in a home or residence. Initial nursing facility care is reported from the nursing facility E/M code family.
What should the note support?
Document the residence setting, the patient's new-patient status, the medically appropriate evaluation, and the straightforward MDM or qualifying total time used to select the code.
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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