CPT code 99348: Home visit, established patient, low MDM or 30 minutes2026 Medicare rate & RVUs in Puerto Rico

In Puerto Rico, Medicare pays $79.08 for 99348 in the office.

Check a contract rate as a % of Medicare · 99348 nationwide

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

What 99348 covers

This visit covers an established patient seen where they live: a private home, apartment, assisted living facility, group home, or another residence outside a skilled nursing or nursing facility. Physicians, nurse practitioners, and physician assistants in house-call, home-based primary care, and geriatric practices typically report it. They may assess an uncomplicated acute illness, review pertinent information, and discuss a low-risk treatment plan with the patient or caregiver. The diagnosis alone does not establish the visit level.

Select 99348 when at least two of the three medical decision-making elements—problems, data, and risk—support low MDM, or when total practitioner time on the visit date reaches at least 30 minutes. If a higher time threshold is met, select the level supported by that time instead. Travel to and from the residence does not count. Documentation should identify the residence setting, clinically appropriate history and exam, problems addressed, pertinent data, and management plan, or support the time reported. Medicare does not require the patient to be homebound for a practitioner home visit. The place of service code identifies the residence type.

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 Puerto Rico compares for 99348

Across 109 of 109 payment localities, the office rate for 99348 runs from $73.97 in Arkansas to $104.54 in Alaska. Puerto Rico pays $79.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99348 rates by state

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

See 99348 in every payment locality

How the 99348 rate is calculated

Each of 99348’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 99348

99348 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.

Codes related to 99348

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 99348 has changed in Puerto Rico

Price 99348 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

• Aceitunas
• Adjuntas
• Aguada
• Aguadilla
• Aguas Buenas
• Aguas Claras
• Aguilita
• Aibonito

Browse all communities in Puerto Rico

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