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CMS RVU26D · Effective 2026-10-01

99306 in El Centro

Office / nonfacility

$198.09

Base rate per service

Facility setting

$165.51

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Evaluation and management

About 99306: Initial nursing facility visit, high complexity

An initial skilled nursing or nursing facility evaluation is reported at this level when high medical decision making or at least 50 minutes supports it.

Code 99306 covers an initial evaluation in a skilled nursing facility (SNF) or nursing facility when high medical decision making (MDM) or qualifying time supports the level. A practitioner may assess a resident after hospitalization for sepsis, stroke with swallowing problems, or worsening heart failure; those diagnoses alone do not establish high MDM. The visit may include reviewing hospital records, reconciling medications, examining the resident, and establishing a treatment plan. For Medicare SNF residents, a physician performs the required initial comprehensive visit; nurse practitioners and physician assistants may perform other medically necessary visits. In a nursing facility, an eligible practitioner not employed by the facility may perform the required initial comprehensive visit when permitted.

Select 99306 by high MDM, which requires two of three elements—problems, data, and risk—or by at least 50 minutes of the reporting practitioner's time on the encounter date. Document the clinical problems, data assessed, management decisions, or personally performed time. Exclude staff time and time spent on separately reported services. The principal physician of record appends Medicare modifier AI to the initial visit; other practitioners' qualifying initial visits are reported without AI. Later visits during the stay use subsequent nursing facility codes. Medicare prolonged time may be reported with G0317 when its threshold is met and 99306 was selected by time.

Where the value comes from

  • Work RVU3.50 · 61%
  • Practice expense (office) RVU2.05 · 35%
  • Malpractice RVU0.23 · 4%

1.3M

Medicare services in 2024 · #117 by national volume

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.

99306 compared with similar codes

Office rates for El Centro, from the same CMS release.

99310

Nursing facility visit

Subsequent visit, high MDM

$167.73

99310 is a subsequent nursing facility visit at high complexity; 99306 is for a qualifying initial visit during the resident's stay.

99223

Initial hospital visit

High decision making or 75 minutes

No office rate

99223 is an initial hospital inpatient or observation visit; 99306 is for an initial evaluation of a resident in a skilled nursing facility or nursing facility.

99345

Home visit

New patient, high complexity

$215.39

99345 covers high-level home or residence visits, including assisted living; 99306 is for patients in a skilled nursing facility or nursing facility.

99305

Nursing facility visit

Initial visit, moderate MDM

$144.55

99305 requires moderate MDM or at least 35 minutes for an initial nursing facility visit. Choose 99306 when high MDM or at least 50 minutes is supported.

The same code, a different location

How does El Centro compare?

In Bakersfield, the office rate for 99306 is $198.85—$0.76 higher than the $198.09 rate in El Centro. Both use the same code, release and participation basis.

99306 across payment areas

Same release and payment basis · bars start at $0

  1. El Centro · This locality

    $198.09

  2. Bakersfield

    $198.85

    $0.76 higher than El Centro

  3. Chico

    $198.05

    $0.04 lower than El Centro

  4. Fresno

    $198.05

    $0.04 lower than El Centro

  5. Hanford-Corcoran

    $198.05

    $0.04 lower than El Centro

  6. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $207.80

    $9.71 higher than El Centro

  7. Madera

    $198.05

    $0.04 lower than El Centro

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 99306 ranges from $179.68 in Arkansas to $252.51 in Alaska*. This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Merced

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Modesto

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Napa

    California · 99306

    Office

    $218.42

    Facility

    $179.24

    $20.33 higher than El Centro for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99306

    Office

    $205.90

    Facility

    $170.76

    $7.81 higher than El Centro for the office setting.

  • Redding

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Rest Of California

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99306

    Office

    $200.61

    Facility

    $168.02

    $2.52 higher than El Centro for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99306

    Office

    $204.86

    Facility

    $170.29

    $6.77 higher than El Centro for the office setting.

  • Salinas

    California · 99306

    Office

    $204.00

    Facility

    $169.55

    $5.91 higher than El Centro for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99306

    Office

    $206.47

    Facility

    $170.91

    $8.38 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99306

    Office

    $228.08

    Facility

    $186.17

    $29.99 higher than El Centro for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 99306

    Office

    $227.82

    Facility

    $185.90

    $29.73 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 99306

    Office

    $232.62

    Facility

    $189.75

    $34.53 higher than El Centro for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 99306

    Office

    $231.55

    Facility

    $188.68

    $33.46 higher than El Centro for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99306

    Office

    $201.00

    Facility

    $167.14

    $2.91 higher than El Centro for the office setting.

  • Santa Cruz-Watsonville

    California · 99306

    Office

    $206.67

    Facility

    $170.55

    $8.58 higher than El Centro for the office setting.

  • Santa Maria-Santa Barbara

    California · 99306

    Office

    $204.13

    Facility

    $169.47

    $6.04 higher than El Centro for the office setting.

  • Santa Rosa-Petaluma

    California · 99306

    Office

    $208.61

    Facility

    $172.11

    $10.52 higher than El Centro for the office setting.

  • Stockton

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Vallejo

    California · 99306

    Office

    $218.04

    Facility

    $178.86

    $19.95 higher than El Centro for the office setting.

  • Visalia

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Yuba City

    California · 99306

    Office

    $198.05

    Facility

    $165.47

    $0.04 lower than El Centro for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99306

    Office

    $212.43

    Facility

    $177.41

    $14.34 higher than El Centro for the office setting.

  • Miami

    Florida · 99306

    Office

    $207.61

    Facility

    $176.67

    $9.52 higher than El Centro for the office setting.

  • Chicago

    Illinois · 99306

    Office

    $204.17

    Facility

    $174.29

    $6.08 higher than El Centro for the office setting.

  • Manhattan

    New York · 99306

    Office

    $216.13

    Facility

    $181.59

    $18.04 higher than El Centro for the office setting.

  • Alaska*

    Alaska · 99306

    Office

    $252.51

    Facility

    $220.85

    $54.42 higher than El Centro for the office setting.

  • Alabama

    Alabama · 99306

    Office

    $181.16

    Facility

    $155.15

    $16.93 lower than El Centro for the office setting.

  • Arkansas

    Arkansas · 99306

    Office

    $179.68

    Facility

    $154.14

    $18.41 lower than El Centro for the office setting.

  • Arizona

    Arizona · 99306

    Office

    $189.83

    Facility

    $161.02

    $8.26 lower than El Centro for the office setting.

  • Colorado

    Colorado · 99306

    Office

    $197.16

    Facility

    $165.53

    $0.93 lower than El Centro for the office setting.

  • Connecticut

    Connecticut · 99306

    Office

    $202.28

    Facility

    $170.27

    $4.19 higher than El Centro for the office setting.

  • Delaware

    Delaware · 99306

    Office

    $192.04

    Facility

    $162.67

    $6.05 lower than El Centro for the office setting.

  • Fort Lauderdale

    Florida · 99306

    Office

    $200.15

    Facility

    $170.04

    $2.06 higher than El Centro for the office setting.

  • Rest Of Florida

    Florida · 99306

    Office

    $193.91

    Facility

    $165.49

    $4.18 lower than El Centro for the office setting.

  • Atlanta

    Georgia · 99306

    Office

    $196.05

    Facility

    $165.85

    $2.04 lower than El Centro for the office setting.

  • Rest Of Georgia

    Georgia · 99306

    Office

    $187.14

    Facility

    $160.62

    $10.95 lower than El Centro for the office setting.

  • Hawaii, Guam

    Hawaii · 99306

    Office

    $199.20

    Facility

    $165.40

    $1.11 higher than El Centro for the office setting.

  • Iowa

    Iowa · 99306

    Office

    $182.60

    Facility

    $155.40

    $15.49 lower than El Centro for the office setting.

  • Idaho

    Idaho · 99306

    Office

    $183.53

    Facility

    $156.18

    $14.56 lower than El Centro for the office setting.

  • East St. Louis

    Illinois · 99306

    Office

    $195.37

    Facility

    $168.02

    $2.72 lower than El Centro for the office setting.

  • Rest Of Illinois

    Illinois · 99306

    Office

    $191.43

    Facility

    $164.28

    $6.66 lower than El Centro for the office setting.

  • Suburban Chicago

    Illinois · 99306

    Office

    $201.65

    Facility

    $171.13

    $3.56 higher than El Centro for the office setting.

  • Indiana

    Indiana · 99306

    Office

    $184.11

    Facility

    $156.55

    $13.98 lower than El Centro for the office setting.

  • Kansas

    Kansas · 99306

    Office

    $182.67

    Facility

    $155.80

    $15.42 lower than El Centro for the office setting.

  • Kentucky

    Kentucky · 99306

    Office

    $184.80

    Facility

    $158.38

    $13.29 lower than El Centro for the office setting.

  • New Orleans

    Louisiana · 99306

    Office

    $190.06

    Facility

    $162.09

    $8.03 lower than El Centro for the office setting.

  • Rest Of Louisiana

    Louisiana · 99306

    Office

    $184.86

    Facility

    $158.55

    $13.23 lower than El Centro for the office setting.

  • Metropolitan Boston

    Massachusetts · 99306

    Office

    $210.29

    Facility

    $174.79

    $12.20 higher than El Centro for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99306

    Office

    $197.00

    Facility

    $165.69

    $1.09 lower than El Centro for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99306

    Office

    $201.75

    Facility

    $169.85

    $3.66 higher than El Centro for the office setting.

  • Rest Of Maryland

    Maryland · 99306

    Office

    $194.42

    Facility

    $164.33

    $3.67 lower than El Centro for the office setting.

  • Rest Of Maine

    Maine · 99306

    Office

    $184.68

    Facility

    $157.33

    $13.41 lower than El Centro for the office setting.

  • Southern Maine

    Maine · 99306

    Office

    $189.61

    Facility

    $160.15

    $8.48 lower than El Centro for the office setting.

  • Detroit

    Michigan · 99306

    Office

    $195.93

    Facility

    $167.24

    $2.16 lower than El Centro for the office setting.

  • Rest Of Michigan

    Michigan · 99306

    Office

    $188.09

    Facility

    $160.95

    $10.00 lower than El Centro for the office setting.

  • Minnesota

    Minnesota · 99306

    Office

    $189.63

    Facility

    $159.05

    $8.46 lower than El Centro for the office setting.

  • Metropolitan Kansas City

    Missouri · 99306

    Office

    $188.70

    Facility

    $160.79

    $9.39 lower than El Centro for the office setting.

  • Metropolitan St. Louis

    Missouri · 99306

    Office

    $189.79

    Facility

    $161.49

    $8.30 lower than El Centro for the office setting.

  • Rest Of Missouri

    Missouri · 99306

    Office

    $183.41

    Facility

    $157.78

    $14.68 lower than El Centro for the office setting.

  • Mississippi

    Mississippi · 99306

    Office

    $181.53

    Facility

    $155.94

    $16.56 lower than El Centro for the office setting.

  • Montana**

    Montana · 99306

    Office

    $193.04

    Facility

    $163.32

    $5.05 lower than El Centro for the office setting.

  • North Carolina

    North Carolina · 99306

    Office

    $185.70

    Facility

    $157.96

    $12.39 lower than El Centro for the office setting.

  • North Dakota**

    North Dakota · 99306

    Office

    $188.49

    Facility

    $158.77

    $9.60 lower than El Centro for the office setting.

  • Nebraska

    Nebraska · 99306

    Office

    $183.01

    Facility

    $155.57

    $15.08 lower than El Centro for the office setting.

  • New Hampshire

    New Hampshire · 99306

    Office

    $194.90

    Facility

    $163.96

    $3.19 lower than El Centro for the office setting.

  • Northern Nj

    New Jersey · 99306

    Office

    $211.90

    Facility

    $177.42

    $13.81 higher than El Centro for the office setting.

  • Rest Of New Jersey

    New Jersey · 99306

    Office

    $204.78

    Facility

    $172.32

    $6.69 higher than El Centro for the office setting.

  • New Mexico

    New Mexico · 99306

    Office

    $188.92

    Facility

    $161.66

    $9.17 lower than El Centro for the office setting.

  • Nevada**

    Nevada · 99306

    Office

    $191.84

    Facility

    $162.09

    $6.25 lower than El Centro for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99306

    Office

    $220.06

    Facility

    $184.72

    $21.97 higher than El Centro for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99306

    Office

    $206.44

    Facility

    $173.89

    $8.35 higher than El Centro for the office setting.

  • Queens

    New York · 99306

    Office

    $216.40

    Facility

    $181.26

    $18.31 higher than El Centro for the office setting.

  • Rest Of New York

    New York · 99306

    Office

    $187.35

    Facility

    $159.11

    $10.74 lower than El Centro for the office setting.

  • Ohio

    Ohio · 99306

    Office

    $187.16

    Facility

    $160.02

    $10.93 lower than El Centro for the office setting.

  • Oklahoma

    Oklahoma · 99306

    Office

    $184.02

    Facility

    $157.47

    $14.07 lower than El Centro for the office setting.

  • Portland

    Oregon · 99306

    Office

    $200.56

    Facility

    $167.53

    $2.47 higher than El Centro for the office setting.

  • Rest Of Oregon

    Oregon · 99306

    Office

    $190.50

    Facility

    $160.89

    $7.59 lower than El Centro for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99306

    Office

    $199.45

    Facility

    $168.51

    $1.36 higher than El Centro for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99306

    Office

    $187.02

    Facility

    $159.73

    $11.07 lower than El Centro for the office setting.

  • Puerto Rico

    Puerto Rico · 99306

    Office

    $193.70

    Facility

    $163.64

    $4.39 lower than El Centro for the office setting.

  • Rhode Island

    Rhode Island · 99306

    Office

    $196.71

    Facility

    $166.00

    $1.38 lower than El Centro for the office setting.

  • South Carolina

    South Carolina · 99306

    Office

    $186.70

    Facility

    $159.23

    $11.39 lower than El Centro for the office setting.

  • South Dakota**

    South Dakota · 99306

    Office

    $187.96

    Facility

    $158.23

    $10.13 lower than El Centro for the office setting.

  • Tennessee

    Tennessee · 99306

    Office

    $183.27

    Facility

    $156.25

    $14.82 lower than El Centro for the office setting.

  • Austin

    Texas · 99306

    Office

    $196.39

    Facility

    $164.94

    $1.70 lower than El Centro for the office setting.

  • Beaumont

    Texas · 99306

    Office

    $186.35

    Facility

    $159.30

    $11.74 lower than El Centro for the office setting.

  • Brazoria

    Texas · 99306

    Office

    $191.69

    Facility

    $162.23

    $6.40 lower than El Centro for the office setting.

  • Dallas

    Texas · 99306

    Office

    $192.74

    Facility

    $163.14

    $5.35 lower than El Centro for the office setting.

  • Fort Worth

    Texas · 99306

    Office

    $192.16

    Facility

    $162.85

    $5.93 lower than El Centro for the office setting.

  • Galveston

    Texas · 99306

    Office

    $192.19

    Facility

    $162.67

    $5.90 lower than El Centro for the office setting.

  • Houston

    Texas · 99306

    Office

    $196.40

    Facility

    $166.88

    $1.69 lower than El Centro for the office setting.

  • Rest Of Texas

    Texas · 99306

    Office

    $188.82

    Facility

    $160.61

    $9.27 lower than El Centro for the office setting.

  • Utah

    Utah · 99306

    Office

    $188.17

    Facility

    $160.22

    $9.92 lower than El Centro for the office setting.

  • Virginia

    Virginia · 99306

    Office

    $189.63

    Facility

    $160.41

    $8.46 lower than El Centro for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99306

    Office

    $193.70

    Facility

    $163.64

    $4.39 lower than El Centro for the office setting.

  • Vermont

    Vermont · 99306

    Office

    $188.58

    Facility

    $159.15

    $9.51 lower than El Centro for the office setting.

  • Rest Of Washington

    Washington · 99306

    Office

    $196.37

    Facility

    $165.07

    $1.72 lower than El Centro for the office setting.

  • Seattle (King Cnty)

    Washington · 99306

    Office

    $213.04

    Facility

    $176.56

    $14.95 higher than El Centro for the office setting.

  • Wisconsin

    Wisconsin · 99306

    Office

    $184.87

    Facility

    $156.39

    $13.22 lower than El Centro for the office setting.

  • West Virginia

    West Virginia · 99306

    Office

    $187.40

    Facility

    $161.57

    $10.69 lower than El Centro for the office setting.

  • Wyoming**

    Wyoming · 99306

    Office

    $191.06

    Facility

    $161.33

    $7.03 lower than El Centro for the office setting.

See how rates vary across the country

99306 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$179.68

$252.51

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$252.511
AL$181.161
AR$179.681
AZ$189.831
CA$198.05–$232.6229
CO$197.161
CT$202.281
DC$212.431
DE$192.041
FL$193.91–$207.613
GA$187.14–$196.052
GU$199.201
HI$199.201
IA$182.601
ID$183.531
IL$191.43–$204.174
IN$184.111
KS$182.671
KY$184.801
LA$184.86–$190.062
MA$197.00–$210.292
MD$194.42–$212.433
ME$184.68–$189.612
MI$188.09–$195.932
MN$189.631
MO$183.41–$189.793
MS$181.531
MT$193.041
NC$185.701
ND$188.491
NE$183.011
NH$194.901
NJ$204.78–$211.902
NM$188.921
NV$191.841
NY$187.35–$220.065
OH$187.161
OK$184.021
OR$190.50–$200.562
PA$187.02–$199.452
PR$193.701
RI$196.711
SC$186.701
SD$187.961
TN$183.271
TX$186.35–$196.408
UT$188.171
VA$189.63–$212.432
VI$193.701
VT$188.581
WA$196.37–$213.042
WI$184.871
WV$187.401
WY$191.061

Explore 99306 on the national rate map →

Where does this rate apply?

El Centro is a Medicare payment area. Our Census mapping connects it to 18 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 99306 in El Centro, the physician’s office rate is $198.09 and the facility-setting rate is $165.51: a difference of $32.58.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99306 in El Centro. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$217.90

$198.09 × 110% = $217.90

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 99306 in El Centro.

PPRRVU2026_Oct_nonQPP.csv

13,047

Code
99306
Physician work
3.50
Practice expense
2.05
Malpractice
0.23

GPCI2026.csv

10

Locality
El Centro
Physician work
1.017
Practice expense
1.096
Malpractice
0.541
Office / nonfacility calculation for 99306 in El Centro
ComponentRVULocality factorAdjusted
Physician work3.50× 1.0173.5595
Practice expense2.05× 1.0962.2468
Malpractice0.23× 0.5410.1244
Total RVUs5.9307
Conversion factor× 33.4009

Office / nonfacility rate, El Centro$198.09

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 99306 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work3.51.017
Practice expense2.051.096
Malpractice0.230.541

(3.5 × 1.017 + 2.05 × 1.096 + 0.23 × 0.541) × $33.4009 = $198.09

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work3.51.017
Practice expense1.161.096
Malpractice0.230.541

(3.5 × 1.017 + 1.16 × 1.096 + 0.23 × 0.541) × $33.4009 = $165.51

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

99306 · Office / nonfacility

$198.09

Effective 2026-10-01

The base rate is $19.13 higher than on 2025-10-01, moving from $178.96 to $198.09 (10.7%).

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

    $178.96changed to$198.09

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.70 changed to 2.05
    • Malpractice RVU 0.22 changed to 0.23
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.570 changed to 0.541

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $178.96

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$198.09$165.51RVU26D
2026-07-01$198.09$165.51RVU26C
2026-04-01$198.09$165.51RVU26B
2026-01-01$198.09$165.51RVU26A
2025-10-01$178.96$178.96RVU25D
2025-07-01$178.96$178.96RVU25C
2025-04-01$178.96$178.96RVU25B
2025-01-01$178.96$178.96RVU25A

99306 billing questions

When should 99306 be chosen over 99305?

Both are initial nursing facility visits. Choose 99306 for high MDM or at least 50 minutes of qualifying time; 99305 requires moderate MDM or at least 35 minutes. When selecting by MDM, document the elements supporting the higher level.

What is modifier AI and when is it appended?

For Medicare, modifier AI identifies the principal physician of record on an initial nursing facility visit. Other practitioners who perform qualifying initial visits report them without AI.

Can a nurse practitioner bill 99306?

A physician must perform the required initial comprehensive visit for a Medicare SNF resident, but a nurse practitioner may report another medically necessary initial visit when supported. In a nursing facility, a qualified nurse practitioner not employed by the facility may perform the required initial comprehensive visit when permitted.

How is prolonged time reported with 99306?

Medicare uses G0317 when the applicable prolonged-service threshold is met; payers following CPT may use 99418. The primary visit must be selected by time, and the prolonged-service requirements must also be met.

Can 99306 be billed if the patient was seen by the same practitioner earlier in the stay?

After that practitioner's initial visit, later visits during the same stay are reported with subsequent nursing facility codes 99307–99310. A new admission after discharge may support another initial visit.

Does activity on other days count toward the 50 minutes?

No. Count only the reporting practitioner's qualifying time on the encounter date, such as chart review, examination, orders, and documentation. Exclude facility staff time and time spent on separately reported services.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 99306PPRRVU2026_Oct_nonQPP.csv, line 13,047 (RVU26D)
Geographic factors for El CentroGPCI2026.csv, line 10 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet