Billing code 99308: Nursing facility visitMedicare rate & RVUs
Report a subsequent skilled nursing or nursing facility visit when the practitioner documents low medical decision making or at least 20 minutes of qualifying time.
Medicare pays $78.83 for 99308 nationally in the office and $67.80 in a hospital or facility. Local office rates run $72.91–$101.46.
Medicare rate · 99308
Nursing facility visit
Swap in your local Medicare rate.
- Work RVUs
- 1.3
- Total RVUs
- 2.36
- Global days
- XXX
National rate · 2026
$78.83
Office setting, before claim adjustments.
See every locality for 99308 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 99308 covers
Physicians, nurse practitioners, and physician assistants report 99308 for a subsequent evaluation of a resident in a skilled nursing facility or nursing facility. The encounter may address ongoing conditions, a new uncomplicated illness, or a change in care needs. Managing two stable chronic illnesses can support the problem element of low medical decision making (MDM), but the overall MDM level depends on at least two of its three elements. Work may include reviewing nursing observations, examining the resident, discussing care with facility staff, and updating treatment orders.
Select 99308 when the documented MDM is low or the reporting practitioner spends at least 20 minutes on qualifying work on the encounter date. Count the practitioner's face-to-face and non-face-to-face E/M work, including chart review, staff discussions, orders, and documentation; exclude facility staff time and time spent on separately reported services. Document the problems and management decisions supporting MDM or the total time supporting time-based selection. Medicare uses the facility rate for place of service (POS) 31, skilled nursing facility, and the nonfacility rate for POS 32, nursing facility.
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 99308 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$72.91 to $101.46
109 of 109 payment localities
99308 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$72.91
$101.46
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $101.46 | 1 |
| AL | $73.57 | 1 |
| AR | $72.91 | 1 |
| AZ | $77.43 | 1 |
| CA | $81.47–$96.83 | 29 |
| CO | $80.86 | 1 |
| CT | $82.78 | 1 |
| DC | $87.30 | 1 |
| DE | $78.38 | 1 |
| FL | $78.73–$84.25 | 3 |
| GA | $75.80–$80.02 | 2 |
| GU | $82.19 | 1 |
| HI | $82.19 | 1 |
| IA | $74.43 | 1 |
| ID | $74.80 | 1 |
| IL | $77.48–$82.75 | 4 |
| IN | $75.06 | 1 |
| KS | $74.36 | 1 |
| KY | $74.97 | 1 |
| LA | $74.95–$77.26 | 2 |
| MA | $80.71–$86.66 | 2 |
| MD | $79.43–$87.30 | 3 |
| ME | $75.20–$77.55 | 2 |
| MI | $76.32–$79.51 | 2 |
| MN | $77.89 | 1 |
| MO | $74.24–$77.26 | 3 |
| MS | $73.58 | 1 |
| MT | $78.82 | 1 |
| NC | $75.67 | 1 |
| ND | $77.24 | 1 |
| NE | $74.64 | 1 |
| NH | $79.83 | 1 |
| NJ | $83.83–$86.98 | 2 |
| NM | $76.65 | 1 |
| NV | $78.41 | 1 |
| NY | $76.40–$90.08 | 5 |
| OH | $76.00 | 1 |
| OK | $74.73 | 1 |
| OR | $77.90–$82.47 | 2 |
| PA | $76.00–$81.47 | 2 |
| PR | $79.15 | 1 |
| RI | $80.44 | 1 |
| SC | $75.94 | 1 |
| SD | $77.05 | 1 |
| TN | $74.61 | 1 |
| TX | $75.69–$80.51 | 8 |
| UT | $76.59 | 1 |
| VA | $77.48–$87.30 | 2 |
| VI | $79.15 | 1 |
| VT | $77.18 | 1 |
| WA | $80.49–$87.94 | 2 |
| WI | $75.60 | 1 |
| WV | $75.69 | 1 |
| WY | $78.13 | 1 |
How the 99308 rate is calculated
Each of 99308’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 · 99308
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.30Practice expense 0.98Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99308
99308 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 · 99308
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$78.83
The facility rate would be $67.80 (+$11.03). In a facility, the facility bills its own costs separately.
99308 compared with similar codes
Compare codes
99308 vs 99307 vs 99309 vs 99304 vs 99348: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 99307Nursing facility visit
- 99307 requires straightforward MDM or at least 10 minutes. Choose 99308 when the overall MDM is low or qualifying time reaches 20 minutes.
- 99309Nursing facility visit
- 99309 requires moderate MDM or at least 30 minutes; 99308 requires low MDM or at least 20 minutes. A worsening condition or prescription drug management alone does not determine the overall MDM level.
- 99304Nursing facility care
- 99304 is for an initial nursing facility evaluation with straightforward or low MDM or at least 25 minutes. Use 99308 for a subsequent evaluation meeting its low-MDM or 20-minute threshold.
- 99348Home visit
- 99348 is for an established patient seen in a home or residence setting, including assisted living. Use the nursing facility visit family for skilled nursing or nursing facility residents, selecting 99308 when its level criteria are met.
99308 billing questions
How do I choose between this code and 99309?
Use 99308 for low MDM or at least 20 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes; prescription drug management alone does not establish moderate MDM.
Can a nurse practitioner bill this visit?
Yes. Nurse practitioners and physician assistants may report subsequent nursing facility visits under their own NPI, subject to Medicare and state scope-of-practice requirements.
What time counts toward the 20 minutes?
Count the reporting practitioner's qualifying work on the encounter date, such as reviewing records, examining the resident, speaking with nursing staff or family, entering orders, and documenting. Exclude facility staff time and time spent on separately reported services.
Which place of service do I use?
Use POS 31 for a skilled nursing facility and POS 32 for a nursing facility. Medicare uses the facility rate for POS 31 and the nonfacility rate for POS 32.
Can I bill this on the day the resident is discharged from the facility?
When the practitioner performs discharge-day management, report 99315 or 99316 for that work rather than 99308. Select the discharge code based on the time spent on discharge management.
Can prolonged service time be added to this level?
No. Medicare's prolonged nursing facility E/M service for subsequent care pairs with 99310 when its time requirements are met, rather than with 99308.
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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