CPT code 99347: Home visit, established patient, straightforward MDM2026 Medicare rate & RVUs in Michigan
Established-patient home or residence E/M for a straightforward problem, reported when documented decision-making or at least 20 minutes of clinician time supports this level.
Medicare pays $44.99–$46.50 for 99347 in the office in Michigan, from Rest of Michigan to Detroit, MI. 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 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 in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $46.50 | Unavailable |
| Rest of Michigan | $44.99 | Unavailable |
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.
How the rate is built · 99347
RVUs × geographic indexes × conversion factor
Work0.90
0.90 RVUs× 1.000 GPCI
Practice expense0.44
0.44 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.3800
Conversion factor
$33.4009
Medicare rate
$46.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
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.
Place of service · 99347
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$46.09
Higher because the practice carries its own overhead.
99347 compared with similar codes
Compare codes · National
4 codes, side by side
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.
99347 billing questions
How does 99347 differ from 99348?
99347 represents straightforward MDM or at least 20 minutes when selected by time. Use 99348 for low MDM or at least 30 minutes.
Can time determine the code instead of MDM?
Yes. When selecting by time, the clinician must document at least 20 minutes on the date of the encounter; there is no upper time limit for this level.
Can this code be used for an assisted living visit?
Yes, when the encounter is an E/M service in the patient’s residence and the patient is established. A nursing-facility E/M encounter belongs to a different service family.
How is 99347 different from 99341?
Both represent straightforward MDM, but 99347 is for an established patient and 99341 is for a new patient. Their time thresholds also differ.
When might modifier 25 be reported with 99347?
Append modifier 25 when a separately identifiable E/M service is performed on the same date as a procedure and the documentation supports both 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
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