CPT code 99347: Home visit, established patient, straightforward MDM2026 Medicare rate & RVUs

Medicare pays $46.09 for 99347 nationally in the office. Local office rates run $43.37–$61.48.

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

What 99347 covers

99347 is for an E/M encounter with an established patient in a home or residence. A physician or other qualified health care professional assesses the patient’s concern, evaluates relevant history and findings, and develops or updates a straightforward care plan. The setting may be a private home or another residence, such as an assisted living facility or group home. This is not the nursing-facility E/M service family.

Select the level by medical decision-making or, when using time, the clinician’s total time on the date of the encounter. The record should support straightforward MDM, or document at least 20 minutes when time determines the level. Include the patient’s relevant problem, assessment, and plan, and make clear that the service occurred in the home or residence. Report one E/M service for the encounter rather than treating the time threshold as a unit count.

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 99347 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

99347 rates by state

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

How the 99347 rate is calculated

Each of 99347’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 99347

99347 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.

99347 compared with similar codes

How to choose

99348Home visitEstablished patient, low MDM or 30 minutes

Choose 99347 for straightforward MDM or at least 20 minutes by time. Choose 99348 when low MDM or at least 30 minutes supports the higher level.

99349Home visitEstablished patient, moderate complexity

99349 requires moderate MDM or at least 40 minutes when selected by time; 99347 is for straightforward MDM or at least 20 minutes.

99341Home visitNew patient, straightforward MDM

99341 is the new-patient home or residence E/M level for straightforward MDM. 99347 is for an established patient.

Codes related to 99347

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