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

Home or residence E/M visit for an established patient, selected by low medical decision making or at least 30 minutes of practitioner time that day.

CMS RVU26DEffective Oct 1, 2026One payment locality1.8M Medicare services in 2024

In Vermont, Medicare pays $77.41 for 99348 in the office.

$77.41Office (non-facility)
Not available in this settingHospital or facility
−1.8%vs the national office rate ($78.83)

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.

We’ll open 99348 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 99348 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 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 Vermont 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. Vermont pays $77.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

99348 in Vermont vs other payment areas
  1. Vermont · this page$77.41
  2. Los Angeles, CA · California$84.92+$7.51
  3. Washington, DC area · District of Columbia$86.49+$9.08
  4. Miami, FL · Florida$83.48+$6.07
  5. Chicago, IL · Illinois$82.34+$4.93
  6. Manhattan, NY · New York$87.68+$10.27
  7. Alaska · Alaska$104.54+$27.13

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

Every other payment area

99348 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$74.51—
ArkansasArkansas$73.97—
ArizonaArizona$77.67—
Bakersfield, CACalifornia$81.40—
Chico, CACalifornia$81.13—
El Centro, CACalifornia$81.14—
Fresno, CACalifornia$81.13—
Hanford, CACalifornia$81.13—

99348 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.

$73.97

$104.54

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

View every state and territory as a table
99348 office rate range by state
State / territoryOffice rate rangeLocalities
AK$104.541
AL$74.511
AR$73.971
AZ$77.671
CA$81.13–$94.9229
CO$80.601
CT$82.351
DC$86.491
DE$78.521
FL$78.84–$83.483
GA$76.43–$79.872
GU$81.461
HI$81.461
IA$75.171
ID$75.481
IL$77.85–$82.344
IN$75.701
KS$75.131
KY$75.701
LA$75.69–$77.592
MA$80.55–$85.742
MD$79.45–$86.493
ME$75.83–$77.732
MI$76.83–$79.512
MN$77.951
MO$75.12–$77.563
MS$74.551
MT$78.821
NC$76.211
ND$77.441
NE$75.341
NH$79.621
NJ$83.48–$86.362
NM$77.111
NV$78.461
NY$76.81–$89.025
OH$76.551
OK$75.481
OR$78.03–$81.962
PA$76.53–$81.262
PR$79.081
RI$80.401
SC$76.471
SD$77.271
TN$75.341
TX$76.29–$80.198
UT$77.001
VA$77.69–$86.492
VI$79.081
VT$77.411
WA$80.32–$86.892
WI$76.101
WV$76.381
WY$78.221

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.

How the rate is built · 99348

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense0.79

0.79 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

2.3600

Conversion factor

$33.4009

Medicare rate

$78.83

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

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

13,059

Code
99348
Physician work
1.50
Practice expense
0.79
Malpractice
0.07

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 99348 in Vermont
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0001.5000
Practice expense0.79× 0.9900.7821
Malpractice0.07× 0.5060.0354
Total RVUs2.3175
Conversion factor× 33.4009

Office rate, Vermont$77.41

Office: (1.5 × 1 + 0.79 × 0.99 + 0.07 × 0.506) × $33.4009 = $77.41

Open 99348 in the RVU calculator

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.

Place of service · 99348

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$78.83

Higher because the practice carries its own overhead.

How 99348 has changed in Vermont

99348 · Office / nonfacility

$77.41

Effective 2026-10-01

The base rate is $4.74 higher than on 2025-10-01, moving from $72.67 to $77.41 (6.5%).

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

    $72.67changed to$77.41

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.71 changed to 0.79
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $74.45changed to$72.67

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.70 changed to 0.71

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $73.23changed to$74.45

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $74.94changed to$73.23

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.67 changed to 0.70
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518
  5. January 1, 2023

    RVU23A

    $81.74changed to$74.94

    • Conversion factor 34.6062 changed to 33.8872
    • Work RVU 1.56 changed to 1.50
    • Practice expense RVU 0.75 changed to 0.67
    • Malpractice RVU 0.09 changed to 0.08
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $82.42changed to$81.74

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $84.38changed to$82.42

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.72 changed to 0.75
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $84.19changed to$84.38

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.70 changed to 0.72
    • Malpractice RVU 0.11 changed to 0.09
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $84.46changed to$84.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.71 changed to 0.70

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $84.24changed to$84.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $83.70changed to$84.24

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.70 changed to 0.71
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $83.76changed to$83.70

    • Conversion factor 35.9335 changed to 35.8043
    • Malpractice RVU 0.10 changed to 0.11

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $83.34changed to$83.76

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $83.32changed to$83.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$83.32

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$77.41Not available in this settingRVU26D
2026-07-01$77.41Not available in this settingRVU26C
2026-04-01$77.41Not available in this settingRVU26B
2026-01-01$77.41Not available in this settingRVU26A
2025-10-01$72.67Not available in this settingRVU25D
2025-07-01$72.67Not available in this settingRVU25C
2025-04-01$72.67Not available in this settingRVU25B
2025-01-01$72.67Not available in this settingRVU25A
2024-10-01$74.45Not available in this settingRVU24D
2024-07-01$74.45Not available in this settingRVU24C
2024-04-01$74.45Not available in this settingRVU24B
2024-03-09$74.45Not available in this settingRVU24AR
2024-01-01$73.23Not available in this settingRVU24A
2023-10-01$74.94Not available in this settingRVU23D
2023-07-01$74.94Not available in this settingRVU23C
2023-04-01$74.94Not available in this settingRVU23B
2023-01-01$74.94Not available in this settingRVU23A
2022-10-01$81.74Not available in this settingRVU22D
2022-07-01$81.74Not available in this settingRVU22C
2022-04-01$81.74Not available in this settingRVU22B
2022-01-01$81.74Not available in this settingRVU22A
2021-10-01$82.42Not available in this settingRVU21D
2021-07-01$82.42Not available in this settingRVU21C
2021-04-01$82.42Not available in this settingRVU21B
2021-01-01$82.42Not available in this settingRVU21A
2020-10-01$84.38Not available in this settingRVU20D
2020-07-01$84.38Not available in this settingRVU20C
2020-04-01$84.38Not available in this settingRVU20B
2020-01-01$84.38Not available in this settingRVU20A
2019-10-01$84.19Not available in this settingRVU19D
2019-07-01$84.19Not available in this settingRVU19C
2019-04-01$84.19Not available in this settingRVU19B
2019-01-01$84.19Not available in this settingRVU19A
2018-10-01$84.46Not available in this settingRVU18D
2018-07-01$84.46Not available in this settingRVU18C
2018-04-01$84.46Not available in this settingRVU18B
2018-01-01$84.46Not available in this settingRVU18AR1
2017-10-01$84.24Not available in this settingRVU17D
2017-07-01$84.24Not available in this settingRVU17C
2017-04-01$84.24Not available in this settingRVU17B
2017-01-01$84.24Not available in this settingRVU17A
2016-10-01$83.70Not available in this settingRVU16D
2016-07-01$83.70Not available in this settingRVU16C
2016-04-01$83.70Not available in this settingRVU16B
2016-01-01$83.70Not available in this settingRVU16A
2015-10-01$83.76Not available in this settingRVU15D
2015-07-01$83.76Not available in this settingRVU15C
2015-04-01$83.34Not available in this settingRVU15B
2015-01-01$83.34Not available in this settingRVU15A
2014-10-01$83.32Not available in this settingRVU14D
2014-07-01$83.32Not available in this settingRVU14C
2014-04-01$83.32Not available in this settingRVU14B
2014-01-01$83.32Not available in this settingRVU14A
2013-10-01Rate data unavailableNot 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 99348 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

99348 billing questions

When should 99348 be chosen over 99349?

Choose 99348 for low MDM or at least 30 minutes when selecting by time. Choose 99349 for moderate MDM or at least 40 minutes; moderate MDM requires two qualifying moderate elements.

Can this code be used for patients living in assisted living facilities?

Yes. Visits in assisted living, group homes, and similar residences are reported with the home or residence E/M series, using the appropriate place of service.

Does travel time count toward the 30 minutes?

No. Count the reporting practitioner's qualifying time spent on the patient's care on the visit date, such as reviewing records, examining, counseling, ordering, and documenting. Exclude time driving to or from the residence.

Can 99348 be reported for a resident of a skilled nursing or nursing facility?

No. Use the appropriate nursing facility E/M code, such as a subsequent nursing facility visit code from 99307-99310, rather than the home or residence series.

What makes a patient established for this code?

The patient received professional services within the past three years from the same practitioner or another practitioner of the same specialty and subspecialty in the same group. Otherwise, consider a new-patient home visit code such as 99342 when its level criteria are met.

What documentation supports low medical decision making?

Document the problems addressed, any data reviewed or analyzed, and management decisions so that at least two of the three MDM elements support the low level. A diagnosis by itself does not establish low MDM.

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 99348PPRRVU2026_Oct_nonQPP.csv, line 13,059 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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