Billing code 99350: Home visitMedicare rate & RVUs

Medicare pays $193.06 for 99350 nationally in the office. Local office rates run $180.03–$253.79.

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.

Where 99350 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

99350 rates by state

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

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.

99350 compared with similar codes

How to choose

99349Home visit

99349 requires moderate medical decision making or at least 40 minutes when 99350 criteria are not met. 99350 requires high medical decision making or at least 60 minutes.

99345Home visit

99345 is for a new patient: no qualifying professional service from the same specialty and subspecialty in the group within the past three years. 99350 is for an established patient.

99215Office visit

99215 is an established-patient office or outpatient visit with high medical decision making or at least 40 minutes. Use 99350 for a qualifying home or residence visit with high decision making or at least 60 minutes.

99310Nursing facility visit

99310 is a high-level subsequent nursing facility visit. 99350 is for an established patient seen in a private home or qualifying residential setting, such as assisted living.

Codes related to 99350

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

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