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

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.

CMS RVU26DEffective Oct 1, 2026One payment locality509.1K Medicare services in 2024

In South Dakota, Medicare pays $45.21 for 99347 in the office.

$45.21Office (non-facility)
Not available in this settingHospital or facility
−1.9%vs the national office rate ($46.09)

Check a contract rate as a % of Medicare · 99347 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 99347 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in South Dakota
  2. What 99347 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 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.

How South Dakota compares for 99347

Across 109 of 109 payment localities, the office rate for 99347 runs from $43.37 in Arkansas to $61.48 in Alaska. South Dakota pays $45.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

99347 in South Dakota vs other payment areas
  1. South Dakota · this page$45.21
  2. Los Angeles, CA · California$49.57+$4.36
  3. Washington, DC area · District of Columbia$50.48+$5.27
  4. Miami, FL · Florida$48.74+$3.53
  5. Chicago, IL · Illinois$48.11+$2.90
  6. Manhattan, NY · New York$51.18+$5.97
  7. Alaska · Alaska$61.48+$16.27

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

Every other payment area

99347 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$43.68—
ArkansasArkansas$43.37—
ArizonaArizona$45.45—
Bakersfield, CACalifornia$47.55—
Chico, CACalifornia$47.40—
El Centro, CACalifornia$47.40—
Fresno, CACalifornia$47.40—
Hanford, CACalifornia$47.40—

99347 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.

$43.37

$61.48

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

View every state and territory as a table
99347 office rate range by state
State / territoryOffice rate rangeLocalities
AK$61.481
AL$43.681
AR$43.371
AZ$45.451
CA$47.40–$55.2829
CO$47.101
CT$48.111
DC$50.481
DE$45.931
FL$46.12–$48.743
GA$44.76–$46.692
GU$47.541
HI$47.541
IA$44.041
ID$44.211
IL$45.57–$48.114
IN$44.331
KS$44.021
KY$44.351
LA$44.35–$45.412
MA$47.08–$50.032
MD$46.46–$50.483
ME$44.41–$45.472
MI$44.99–$46.502
MN$45.581
MO$44.03–$45.393
MS$43.701
MT$46.091
NC$44.631
ND$45.301
NE$44.131
NH$46.531
NJ$48.78–$50.432
NM$45.141
NV$45.881
NY$44.96–$51.945
OH$44.831
OK$44.221
OR$45.64–$47.862
PA$44.81–$47.492
PR$46.231
RI$47.011
SC$44.781
SD$45.211
TN$44.141
TX$44.68–$46.858
UT$45.081
VA$45.45–$50.482
VI$46.231
VT$45.291
WA$46.94–$50.692
WI$44.551
WV$44.741
WY$45.751

See 99347 in every payment locality

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

Office or facility?

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.

The exact South Dakota inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,058

Code
99347
Physician work
0.90
Practice expense
0.44
Malpractice
0.04

GPCI2026.csv

94

Locality
South Dakota
Physician work
1.000
Practice expense
1.000
Malpractice
0.336
Office calculation for 99347 in South Dakota
ComponentRVULocality factorAdjusted
Physician work0.90× 1.0000.9000
Practice expense0.44× 1.0000.4400
Malpractice0.04× 0.3360.0134
Total RVUs1.3534
Conversion factor× 33.4009

Office rate, South Dakota$45.21

Office: (0.9 × 1 + 0.44 × 1 + 0.04 × 0.336) × $33.4009 = $45.21

Open 99347 in the RVU calculator

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.

How 99347 has changed in South Dakota

99347 · Office / nonfacility

$45.21

Effective 2026-10-01

The base rate is $2.34 higher than on 2025-10-01, moving from $42.87 to $45.21 (5.5%).

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

    $42.87changed to$45.21

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.41 changed to 0.44
    • Malpractice GPCI 0.382 changed to 0.336

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $43.91changed to$42.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.40 changed to 0.41
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $43.19changed to$43.91

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $43.87changed to$43.19

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.38 changed to 0.40
    • Malpractice RVU 0.04 changed to 0.05
    • Malpractice GPCI 0.364 changed to 0.382
  5. January 1, 2023

    RVU23A

    $53.55changed to$43.87

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.00 changed to 0.90
    • Practice expense RVU 0.53 changed to 0.38
    • Malpractice RVU 0.05 changed to 0.04
    • Malpractice GPCI 0.347 changed to 0.364

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $53.64changed to$53.55

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.52 changed to 0.53

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $54.44changed to$53.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.49 changed to 0.52
    • Malpractice GPCI 0.368 changed to 0.347

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $54.68changed to$54.44

    • Conversion factor 36.0391 changed to 36.0896
    • Malpractice RVU 0.07 changed to 0.05
    • Malpractice GPCI 0.389 changed to 0.368

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $54.62changed to$54.68

    • Conversion factor 35.9996 changed to 36.0391

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $54.47changed to$54.62

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 0.395 changed to 0.389

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $54.35changed to$54.47

    • Conversion factor 35.8043 changed to 35.8887
    • Malpractice GPCI 0.400 changed to 0.395

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $54.76changed to$54.35

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 0.50 changed to 0.49
    • Malpractice RVU 0.06 changed to 0.07

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $54.49changed to$54.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $54.42changed to$54.49

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.49 changed to 0.50
    • Malpractice RVU 0.07 changed to 0.06
    • Malpractice GPCI 0.416 changed to 0.400

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $53.08changed to$54.42

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.53 changed to 0.49
    • Malpractice GPCI 0.432 changed to 0.416

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $53.08

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$45.21Not available in this settingRVU26D
2026-07-01$45.21Not available in this settingRVU26C
2026-04-01$45.21Not available in this settingRVU26B
2026-01-01$45.21Not available in this settingRVU26A
2025-10-01$42.87Not available in this settingRVU25D
2025-07-01$42.87Not available in this settingRVU25C
2025-04-01$42.87Not available in this settingRVU25B
2025-01-01$42.87Not available in this settingRVU25A
2024-10-01$43.91Not available in this settingRVU24D
2024-07-01$43.91Not available in this settingRVU24C
2024-04-01$43.91Not available in this settingRVU24B
2024-03-09$43.91Not available in this settingRVU24AR
2024-01-01$43.19Not available in this settingRVU24A
2023-10-01$43.87Not available in this settingRVU23D
2023-07-01$43.87Not available in this settingRVU23C
2023-04-01$43.87Not available in this settingRVU23B
2023-01-01$43.87Not available in this settingRVU23A
2022-10-01$53.55Not available in this settingRVU22D
2022-07-01$53.55Not available in this settingRVU22C
2022-04-01$53.55Not available in this settingRVU22B
2022-01-01$53.55Not available in this settingRVU22A
2021-10-01$53.64Not available in this settingRVU21D
2021-07-01$53.64Not available in this settingRVU21C
2021-04-01$53.64Not available in this settingRVU21B
2021-01-01$53.64Not available in this settingRVU21A
2020-10-01$54.44Not available in this settingRVU20D
2020-07-01$54.44Not available in this settingRVU20C
2020-04-01$54.44Not available in this settingRVU20B
2020-01-01$54.44Not available in this settingRVU20A
2019-10-01$54.68Not available in this settingRVU19D
2019-07-01$54.68Not available in this settingRVU19C
2019-04-01$54.68Not available in this settingRVU19B
2019-01-01$54.68Not available in this settingRVU19A
2018-10-01$54.62Not available in this settingRVU18D
2018-07-01$54.62Not available in this settingRVU18C
2018-04-01$54.62Not available in this settingRVU18B
2018-01-01$54.62Not available in this settingRVU18AR1
2017-10-01$54.47Not available in this settingRVU17D
2017-07-01$54.47Not available in this settingRVU17C
2017-04-01$54.47Not available in this settingRVU17B
2017-01-01$54.47Not available in this settingRVU17A
2016-10-01$54.35Not available in this settingRVU16D
2016-07-01$54.35Not available in this settingRVU16C
2016-04-01$54.35Not available in this settingRVU16B
2016-01-01$54.35Not available in this settingRVU16A
2015-10-01$54.76Not available in this settingRVU15D
2015-07-01$54.76Not available in this settingRVU15C
2015-04-01$54.49Not available in this settingRVU15B
2015-01-01$54.49Not available in this settingRVU15A
2014-10-01$54.42Not available in this settingRVU14D
2014-07-01$54.42Not available in this settingRVU14C
2014-04-01$54.42Not available in this settingRVU14B
2014-01-01$54.42Not available in this settingRVU14A
2013-10-01$53.08Not available in this settingRVU13D
2013-07-01$53.08Not available in this settingRVU13C
2013-04-01$53.08Not available in this settingRVU13B
2013-01-01$53.08Not available in this settingRVU13AR

Price 99347 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Agar
  • Agency Village
  • Akaska
  • Albee
  • Alcester
  • Alexandria
  • Allen

Browse all communities in South Dakota

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
RVUs for 99347PPRRVU2026_Oct_nonQPP.csv, line 13,058 (RVU26D)
Geographic factors for South DakotaGPCI2026.csv, line 94 (RVU26D)

Open CMS sourceHow we calculate rates

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