CPT code 99344: Home visit, new patient, moderate complexity2026 Medicare rate & RVUs

Medicare pays $146.63 for 99344 nationally in the office. Local office rates run $137.63–$195.11.

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

What 99344 covers

A physician or other qualified health care professional evaluates a new patient in the patient’s home or another residential setting, such as an assisted-living residence or group home. The visit may address an acute concern, a change in chronic disease, medication management, or several ongoing conditions when care is provided in the residence. The clinician obtains a medically appropriate history and/or examination and develops or updates the plan of care; this code is for a home or residential encounter, not a nursing-facility visit.

Select 99344 when the documented medical decision making is moderate. Alternatively, code selection may use total qualifying physician or qualified health care professional time on the encounter date; 60 minutes must be met or exceeded. Documentation should establish new-patient status and the residence setting, and support the problems assessed, data reviewed, and management risk underlying the level selected. CMS pays the service under the physician fee schedule, with relative value units for clinician work, practice expense, and malpractice.

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 99344 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

99344 rates by state

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

How the 99344 rate is calculated

Each of 99344’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 99344

99344 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.

99344 compared with similar codes

How to choose

99342Home visitNew patient, low MDM

Use 99342 for a new-patient home or residence visit supported by low medical decision making or its time threshold; 99344 requires moderate decision making or at least 60 minutes.

99345Home visitNew patient, high complexity

99345 represents the high medical decision-making level for a new-patient home or residence visit. Choose 99344 when the documented level is moderate instead.

99349Home visitEstablished patient, moderate complexity

99349 is the moderate-level home or residence visit for an established patient. 99344 is for a patient who meets the new-patient definition.

99309Nursing facility visitSubsequent, moderate MDM or 30 minutes

99309 is subsequent nursing-facility care at a moderate level. 99344 applies to a new-patient encounter in a home or residential setting.

Codes related to 99344

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