HCPCS G0317: Prolonged E/MMedicare rate & RVUs
Reports qualifying additional time spent on a nursing facility evaluation and management service when a high-level visit requires prolonged clinician work.
Medicare pays $33.73 for G0317 nationally in the office and $27.05 in a hospital or facility. Local office rates run $31.39–$44.10.
Medicare rate · G0317
Prolonged E/M
Swap in your local Medicare rate.
- Work RVUs
- 0.61
- Total RVUs
- 1.01
- Global days
- ZZZ
National rate · 2026
$33.73
Office setting, before claim adjustments.
See every locality for G0317 → · 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 G0317 covers
G0317 represents additional time spent by a physician or qualified health care professional on a nursing facility evaluation and management service. It may be relevant when an initial nursing facility assessment or a subsequent visit requires unusually extensive work, such as reviewing a complex medical record, evaluating the resident, discussing the plan with family or facility staff, and coordinating care. The additional time must be attributable to the nursing facility E/M service, not simply the time the clinician is present in the facility.
Report G0317 only with the qualifying primary nursing facility E/M service, 99306 or 99310, when documented total time exceeds the time represented by that primary service. Record the clinician’s qualifying work and total time for the date, separating time already counted toward the base visit from additional time. Each unit represents an additional 15 minutes, subject to the applicable time threshold. CMS classifies G0317 as an add-on code; payment is made with the primary procedure and within that procedure’s global period.
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 G0317 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
$31.39 to $44.10
109 of 109 payment localities
G0317 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.
$31.39
$44.10
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 | $44.10 | 1 |
| AL | $31.65 | 1 |
| AR | $31.39 | 1 |
| AZ | $33.17 | 1 |
| CA | $34.62–$40.67 | 29 |
| CO | $34.46 | 1 |
| CT | $35.35 | 1 |
| DC | $37.13 | 1 |
| DE | $33.56 | 1 |
| FL | $33.88–$36.27 | 3 |
| GA | $32.69–$34.26 | 2 |
| GU | $34.82 | 1 |
| HI | $34.82 | 1 |
| IA | $31.91 | 1 |
| ID | $32.07 | 1 |
| IL | $33.44–$35.67 | 4 |
| IN | $32.17 | 1 |
| KS | $31.92 | 1 |
| KY | $32.29 | 1 |
| LA | $32.30–$33.21 | 2 |
| MA | $34.43–$36.76 | 2 |
| MD | $33.97–$37.13 | 3 |
| ME | $32.27–$33.13 | 2 |
| MI | $32.86–$34.23 | 2 |
| MN | $33.14 | 1 |
| MO | $32.04–$33.16 | 3 |
| MS | $31.71 | 1 |
| MT | $33.73 | 1 |
| NC | $32.45 | 1 |
| ND | $32.94 | 1 |
| NE | $31.98 | 1 |
| NH | $34.06 | 1 |
| NJ | $35.79–$37.03 | 2 |
| NM | $33.01 | 1 |
| NV | $33.52 | 1 |
| NY | $32.74–$38.46 | 5 |
| OH | $32.70 | 1 |
| OK | $32.15 | 1 |
| OR | $33.29–$35.05 | 2 |
| PA | $32.68–$34.85 | 2 |
| PR | $33.85 | 1 |
| RI | $34.37 | 1 |
| SC | $32.62 | 1 |
| SD | $32.85 | 1 |
| TN | $32.02 | 1 |
| TX | $32.56–$34.32 | 8 |
| UT | $32.88 | 1 |
| VA | $33.14–$37.13 | 2 |
| VI | $33.85 | 1 |
| VT | $32.95 | 1 |
| WA | $34.32–$37.24 | 2 |
| WI | $32.31 | 1 |
| WV | $32.74 | 1 |
| WY | $33.39 | 1 |
How the G0317 rate is calculated
Each of G0317’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 · G0317
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.61Practice expense 0.36Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for G0317
The CMS indicators that decide how G0317 is paid alongside other services.
CMS payment indicators · G0317
Prolonged E/M
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
G0317 compared with similar codes
Compare codes
G0317 vs 99306 vs 99310 vs G0316 vs G0318: national Medicare rates
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How to choose
- 99306Nursing facility visit
- 99306 reports the initial nursing facility E/M service itself. G0317 is added only when qualifying time extends beyond that primary service’s time.
- 99310Nursing facility visit
- 99310 reports a subsequent nursing facility E/M service. G0317 may be added for qualifying time beyond the primary service’s time.
- G0316Prolonged E/M
- G0316 is the prolonged-service add-on for qualifying inpatient or observation E/M services; G0317 is for nursing facility E/M services.
- G0318Prolonged home visit
- G0318 applies to qualifying prolonged home or residence E/M services. G0317 applies to qualifying nursing facility E/M services.
G0317 billing questions
Which nursing facility visit codes can be paired with G0317?
G0317 is paired with 99306 for qualifying initial nursing facility care or 99310 for qualifying subsequent care. It is not a stand-alone visit code.
When is G0317 appropriate instead of reporting a higher-level visit?
Use the applicable primary visit code based on the service and its selection criteria, then report G0317 only for qualifying additional time beyond the primary service’s time.
What time should the record support?
Document the clinician’s total qualifying time on the date of service and identify the work attributable to the additional time. Do not count time already used to select or support the primary visit.
Can G0317 be billed by itself?
No. It is an add-on code and must be billed with a qualifying primary nursing facility E/M service.
Does G0317 describe a separate procedure or facility service?
No. It reports additional clinician time for the nursing facility E/M service; it does not represent a separate procedure performed by facility staff.
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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