CPT code 99350: Home visit, established patient, high complexity2026 Medicare rate & RVUs in New Mexico

In New Mexico, Medicare pays $189.29 for 99350 in the office.

Check a contract rate as a % of Medicare · 99350 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 99350 covers

Established patients may be seen in a private home or residential setting, including assisted living, a group home, or a domiciliary or rest home. The separate domiciliary visit series was folded into the home or residence codes in 2023. House-call physicians, nurse practitioners, and physician assistants may evaluate worsening heart failure or COPD and consider escalation to hospital care. A diagnosis or residence alone does not establish high medical decision making.

Select 99350 when the visit supports high medical decision making or the billing physician or qualified health care professional spends at least 60 minutes on the service date. For decision making, document the problems addressed, data reviewed, and management risk; two of these three elements must support the selected level. For time, record the total and work performed, such as same-day record review, counseling, care coordination, and documentation. Exclude travel and time spent on separately billed services. Medicare pays the qualifying visit under the physician fee schedule. If selection is based on time and Medicare’s additional-time threshold is met, G0318 may be reported with 99350. Homebound status is not required.

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 New Mexico compares for 99350

Across 109 of 109 payment localities, the office rate for 99350 runs from $180.03 in Arkansas to $253.79 in Alaska. New Mexico pays $189.29. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

99350 rates by state

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

See 99350 in every payment locality

How the 99350 rate is calculated

Each of 99350’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 99350

99350 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 99350

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

How 99350 has changed in New Mexico

Price 99350 for an earlier date of service

Where the New Mexico rate applies

New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.

• Abeytas
• Abiquiu
• Acomita Lake
• Adelino
• Agua Fria
• Alamillo
• Alamo
• Alamogordo

Browse all communities in New Mexico

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