CPT code 99345: Home visit, new patient, high complexity2026 Medicare rate & RVUs in Minnesota

Report for a new patient’s high-complexity evaluation in a home or residence, supported by high medical decision making or at least 75 minutes.

CMS RVU26DEffective Oct 1, 2026One payment locality166.1K Medicare services in 2024

In Minnesota, Medicare pays $206.31 for 99345 in the office.

$206.31Office (non-facility)
Not available in this settingHospital or facility
−1.8%vs the national office rate ($210.09)

Check a contract rate as a % of Medicare · 99345 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 99345 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Minnesota
  2. What 99345 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 99345 covers

This service covers a comprehensive evaluation and management visit for a new patient seen in a private home or another residence, such as an assisted-living setting. A physician or qualified health care professional may address serious or worsening conditions, review relevant records and test results, and make high-risk treatment decisions. The code is for a patient meeting the CPT new-patient definition for the physician or qualified professional’s specialty and group.

Select this level when medical decision making is high, or when the practitioner’s total qualifying time on the date of service reaches at least 75 minutes. For high medical decision making, the documentation should support the complexity of the problems addressed, the data reviewed or analyzed, and the risk of management decisions. Record the residence, clinical assessment, decisions, and any qualifying time used to select the level. Do not include staff time or time spent on separately reported services in the E/M time total.

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 Minnesota compares for 99345

Across 109 of 109 payment localities, the office rate for 99345 runs from $195.87 in Arkansas to $275.83 in Alaska. Minnesota pays $206.31. The RVUs are the same everywhere; the geographic indexes change the dollars.

99345 in Minnesota vs other payment areas
  1. Minnesota · this page$206.31
  2. Los Angeles, CA · California$225.80+$19.49
  3. Washington, DC area · District of Columbia$230.88+$24.57
  4. Miami, FL · Florida$225.82+$19.51
  5. Chicago, IL · Illinois$222.17+$15.86
  6. Manhattan, NY · New York$234.97+$28.66
  7. Alaska · Alaska$275.83+$69.52

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

Every other payment area

99345 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$197.45—
ArkansasArkansas$195.87—
ArizonaArizona$206.65—
Bakersfield, CACalifornia$216.22—
Chico, CACalifornia$215.35—
El Centro, CACalifornia$215.39—
Fresno, CACalifornia$215.35—
Hanford, CACalifornia$215.35—

99345 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.

$195.87

$275.83

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

View every state and territory as a table
99345 office rate range by state
State / territoryOffice rate rangeLocalities
AK$275.831
AL$197.451
AR$195.871
AZ$206.651
CA$215.35–$252.3629
CO$214.441
CT$219.991
DC$230.881
DE$209.031
FL$211.12–$225.823
GA$203.90–$213.312
GU$216.461
HI$216.461
IA$198.921
ID$199.921
IL$208.52–$222.174
IN$200.531
KS$199.021
KY$201.371
LA$201.44–$206.972
MA$214.29–$228.482
MD$211.57–$230.883
ME$201.16–$206.362
MI$204.89–$213.292
MN$206.311
MO$199.92–$206.653
MS$197.881
MT$210.071
NC$202.241
ND$205.131
NE$199.341
NH$212.011
NJ$222.72–$230.372
NM$205.781
NV$208.771
NY$204.00–$239.185
OH$203.881
OK$200.511
OR$207.32–$218.042
PA$203.72–$216.992
PR$210.761
RI$214.031
SC$203.361
SD$204.551
TN$199.661
TX$203.01–$213.768
UT$204.911
VA$206.41–$230.882
VI$210.761
VT$205.251
WA$213.60–$231.422
WI$201.281
WV$204.241
WY$207.921

See 99345 in every payment locality

How the 99345 rate is calculated

Each of 99345’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 · 99345

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.88

3.88 RVUs× 1.000 GPCI

Practice expense2.16

2.16 RVUs× 1.000 GPCI

Malpractice0.25

0.25 RVUs× 1.000 GPCI

Adjusted RVUs

6.2900

Conversion factor

$33.4009

Medicare rate

$210.09

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

The exact Minnesota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,057

Code
99345
Physician work
3.88
Practice expense
2.16
Malpractice
0.25

GPCI2026.csv

66

Locality
Minnesota
Physician work
1.000
Practice expense
1.029
Malpractice
0.296
Office calculation for 99345 in Minnesota
ComponentRVULocality factorAdjusted
Physician work3.88× 1.0003.8800
Practice expense2.16× 1.0292.2226
Malpractice0.25× 0.2960.0740
Total RVUs6.1766
Conversion factor× 33.4009

Office rate, Minnesota$206.31

Office: (3.88 × 1 + 2.16 × 1.029 + 0.25 × 0.296) × $33.4009 = $206.31

Open 99345 in the RVU calculator

Payment rules and modifiers for 99345

99345 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 · 99345

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$210.09

Higher because the practice carries its own overhead.

How 99345 has changed in Minnesota

99345 · Office / nonfacility

$206.31

Effective 2026-10-01

The base rate is $16.71 higher than on 2025-10-01, moving from $189.60 to $206.31 (8.8%).

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

    $189.60changed to$206.31

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.86 changed to 2.16
    • Practice expense GPCI 1.025 changed to 1.029
    • Malpractice GPCI 0.300 changed to 0.296

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $195.80changed to$189.60

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.88 changed to 1.86

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $192.60changed to$195.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $198.13changed to$192.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.85 changed to 1.88
    • Practice expense GPCI 1.019 changed to 1.025
    • Malpractice GPCI 0.326 changed to 0.300
  5. January 1, 2023

    RVU23A

    $212.62changed to$198.13

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 4.09 changed to 3.88
    • Practice expense RVU 1.93 changed to 1.85
    • Malpractice RVU 0.28 changed to 0.25
    • Practice expense GPCI 1.013 changed to 1.019
    • Malpractice GPCI 0.353 changed to 0.326

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $214.40changed to$212.62

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.92 changed to 1.93
    • Malpractice RVU 0.31 changed to 0.28

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $220.61changed to$214.40

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.90 changed to 1.92
    • Malpractice RVU 0.28 changed to 0.31
    • Practice expense GPCI 1.012 changed to 1.013
    • Malpractice GPCI 0.357 changed to 0.353

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $219.55changed to$220.61

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.88 changed to 1.90
    • Practice expense GPCI 1.011 changed to 1.012
    • Malpractice GPCI 0.362 changed to 0.357

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $220.17changed to$219.55

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.90 changed to 1.88
    • Malpractice RVU 0.29 changed to 0.28

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $218.52changed to$220.17

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.87 changed to 1.90
    • Practice expense GPCI 1.016 changed to 1.011
    • Malpractice GPCI 0.341 changed to 0.362

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $216.95changed to$218.52

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.84 changed to 1.87
    • Practice expense GPCI 1.020 changed to 1.016
    • Malpractice GPCI 0.319 changed to 0.341

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $217.50changed to$216.95

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.27 changed to 0.29

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $216.42changed to$217.50

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $215.45changed to$216.42

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.82 changed to 1.84
    • Malpractice RVU 0.25 changed to 0.27
    • Practice expense GPCI 1.016 changed to 1.020
    • Malpractice GPCI 0.301 changed to 0.319

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $208.79changed to$215.45

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.95 changed to 1.82
    • Malpractice RVU 0.26 changed to 0.25
    • Practice expense GPCI 1.012 changed to 1.016
    • Malpractice GPCI 0.282 changed to 0.301

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$208.79

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$206.31Not available in this settingRVU26D
2026-07-01$206.31Not available in this settingRVU26C
2026-04-01$206.31Not available in this settingRVU26B
2026-01-01$206.31Not available in this settingRVU26A
2025-10-01$189.60Not available in this settingRVU25D
2025-07-01$189.60Not available in this settingRVU25C
2025-04-01$189.60Not available in this settingRVU25B
2025-01-01$189.60Not available in this settingRVU25A
2024-10-01$195.80Not available in this settingRVU24D
2024-07-01$195.80Not available in this settingRVU24C
2024-04-01$195.80Not available in this settingRVU24B
2024-03-09$195.80Not available in this settingRVU24AR
2024-01-01$192.60Not available in this settingRVU24A
2023-10-01$198.13Not available in this settingRVU23D
2023-07-01$198.13Not available in this settingRVU23C
2023-04-01$198.13Not available in this settingRVU23B
2023-01-01$198.13Not available in this settingRVU23A
2022-10-01$212.62Not available in this settingRVU22D
2022-07-01$212.62Not available in this settingRVU22C
2022-04-01$212.62Not available in this settingRVU22B
2022-01-01$212.62Not available in this settingRVU22A
2021-10-01$214.40Not available in this settingRVU21D
2021-07-01$214.40Not available in this settingRVU21C
2021-04-01$214.40Not available in this settingRVU21B
2021-01-01$214.40Not available in this settingRVU21A
2020-10-01$220.61Not available in this settingRVU20D
2020-07-01$220.61Not available in this settingRVU20C
2020-04-01$220.61Not available in this settingRVU20B
2020-01-01$220.61Not available in this settingRVU20A
2019-10-01$219.55Not available in this settingRVU19D
2019-07-01$219.55Not available in this settingRVU19C
2019-04-01$219.55Not available in this settingRVU19B
2019-01-01$219.55Not available in this settingRVU19A
2018-10-01$220.17Not available in this settingRVU18D
2018-07-01$220.17Not available in this settingRVU18C
2018-04-01$220.17Not available in this settingRVU18B
2018-01-01$220.17Not available in this settingRVU18AR1
2017-10-01$218.52Not available in this settingRVU17D
2017-07-01$218.52Not available in this settingRVU17C
2017-04-01$218.52Not available in this settingRVU17B
2017-01-01$218.52Not available in this settingRVU17A
2016-10-01$216.95Not available in this settingRVU16D
2016-07-01$216.95Not available in this settingRVU16C
2016-04-01$216.95Not available in this settingRVU16B
2016-01-01$216.95Not available in this settingRVU16A
2015-10-01$217.50Not available in this settingRVU15D
2015-07-01$217.50Not available in this settingRVU15C
2015-04-01$216.42Not available in this settingRVU15B
2015-01-01$216.42Not available in this settingRVU15A
2014-10-01$215.45Not available in this settingRVU14D
2014-07-01$215.45Not available in this settingRVU14C
2014-04-01$215.45Not available in this settingRVU14B
2014-01-01$215.45Not available in this settingRVU14A
2013-10-01$208.79Not available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 99345 for an earlier date of service

Where the Minnesota rate applies

Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.

  • Ada
  • Adams
  • Adrian
  • Afton
  • Aitkin
  • Akeley
  • Albany
  • Albert Lea

Browse all communities in Minnesota

99345 billing questions

When should 99345 be chosen instead of 99344?

Choose 99345 when the encounter supports high medical decision making or at least 75 minutes of qualifying practitioner time. Use 99344 for the lower, moderate-complexity new-patient level.

Does the visit have to meet both high MDM and 75 minutes?

No. The level may be selected by high medical decision making or by meeting the 75-minute time threshold.

Can 99345 be reported for an established patient?

No. For an established patient seen in a home or residence, choose the code in the established-patient series that matches the documented level.

Is a nursing-facility visit reported with 99345?

No. 99345 is for a home or residence visit; nursing-facility E/M services use the nursing-facility code family.

What documentation supports the 75-minute basis?

Document the practitioner’s total qualifying time on the date of service and the work performed. Exclude staff time and time attributable to separately reported services.

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 99345PPRRVU2026_Oct_nonQPP.csv, line 13,057 (RVU26D)
Geographic factors for MinnesotaGPCI2026.csv, line 66 (RVU26D)

Open CMS sourceHow we calculate rates

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