CPT code 99344: Home visit, new patient, moderate complexity2026 Medicare rate & RVUs in Texas
A clinician reports this home or residential evaluation for a new patient when moderate medical decision making or at least 60 minutes supports the service.
Medicare pays $142.16–$149.09 for 99344 in the office in Texas, from Beaumont, TX to Houston, TX. 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 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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$142.16 to $149.09
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $148.85 | Unavailable |
| Beaumont, TX | $142.16 | Unavailable |
| Brazoria, TX | $145.81 | Unavailable |
| Dallas, TX | $146.55 | Unavailable |
| Fort Worth, TX | $146.17 | Unavailable |
| Galveston, TX | $146.16 | Unavailable |
| Houston, TX | $149.09 | Unavailable |
| Rest of Texas | $143.79 | Unavailable |
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.
How the rate is built · 99344
RVUs × geographic indexes × conversion factor
Work2.87
2.87 RVUs× 1.000 GPCI
Practice expense1.36
1.36 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
4.3900
Conversion factor
$33.4009
Medicare rate
$146.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · 99344
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$146.63
Higher because the practice carries its own overhead.
99344 compared with similar codes
Compare codes · National
5 codes, side by side
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.
99344 billing questions
How does 99344 differ from 99342?
99344 requires moderate medical decision making, or at least 60 minutes when selecting by time. 99342 is for low medical decision making or its lower time threshold.
Can time alone support reporting 99344?
Yes. The clinician may select the code based on at least 60 minutes of qualifying time on the encounter date, even when selecting by medical decision making would not support this level.
What makes the patient new for this service?
The patient must not have received professional services within the past three years from the reporting clinician, or another clinician of the same specialty and subspecialty in the same group practice.
Can 99344 be reported for an assisted-living visit?
Yes, when the encounter is an evaluation and management service in the patient’s residence and the patient meets the new-patient criteria. Use a nursing-facility code for an encounter in a nursing facility.
What documentation supports the moderate level?
Document the conditions evaluated, relevant data reviewed, and management decisions and risks that support moderate medical decision making. If selecting by time, document the qualifying work and total time for the encounter date.
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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