FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

99310 in Redding

Office / nonfacility

$167.69

Base rate per service

Facility setting

$142.43

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 99310: Subsequent nursing facility visit, high complexity

Follow-up nursing facility or skilled nursing facility visit for a resident whose care requires high-complexity medical decision making or at least 45 minutes of practitioner time.

This is the highest level in the subsequent nursing facility E/M series. It covers a follow-up visit to a skilled nursing facility or long-term nursing facility resident after the initial evaluation. A practitioner might assess suspected sepsis, new respiratory failure, or a severe heart failure or COPD exacerbation and decide whether hospital transfer or a major change in treatment is needed. Attending physicians, geriatricians, nurse practitioners, and physician assistants commonly provide these visits during facility rounds.

Select 99310 when medical decision making is high or the reporting practitioner's qualifying time on the date of service reaches 45 minutes. High MDM requires two of three elements—problems, data, and management risk—at the high level; a hospitalization decision alone does not establish the overall level. Time may include examining the resident, reviewing records, coordinating with facility staff, and documenting, but excludes staff time and work counted toward another reported service. Document the supporting MDM elements or total qualifying time. If the visit is selected by time and Medicare's prolonged-service threshold is met, G0317 may be reported for eligible additional time.

Where the value comes from

  • Work RVU2.80 · 57%
  • Practice expense (office) RVU1.88 · 38%
  • Malpractice RVU0.21 · 4%

2.2M

Medicare services in 2024 · #75 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.

99310 compared with similar codes

Office rates for Redding, from the same CMS release.

99309

Nursing facility visit

Subsequent, moderate MDM or 30 minutes

$117.88

99309 describes moderate MDM or at least 30 minutes when the higher level is not met; 99310 requires high MDM or at least 45 minutes of qualifying time.

99306

Nursing facility visit

Initial visit, high complexity

$198.05

99306 describes an initial nursing facility evaluation at high MDM; 99310 describes a subsequent nursing facility visit.

99350

Home visit

Established patient, high complexity

$197.60

99350 applies to established patients seen at home or in assisted living and similar residences; 99310 applies to residents in a skilled nursing facility or nursing facility.

99315

Discharge management

30 minutes or less

$88.44

99315 covers nursing facility discharge management of 30 minutes or less. Choose it instead of 99310 when the service furnished is discharge management.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 99310 is $168.39—$0.70 higher than the $167.69 rate in Redding. Both use the same code, release and participation basis.

99310 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $167.69

  2. Bakersfield

    $168.39

    $0.70 higher than Redding

  3. Chico

    $167.69

    The same base rate than Redding

  4. El Centro

    $167.73

    $0.04 higher than Redding

  5. Fresno

    $167.69

    The same base rate than Redding

  6. Hanford-Corcoran

    $167.69

    The same base rate than Redding

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

    $176.30

    $8.61 higher than Redding

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, 99310 ranges from $151.07 in Arkansas to $211.02 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

  • Madera

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Merced

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Modesto

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Napa

    California · 99310

    Office

    $185.74

    Facility

    $155.36

    $18.05 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99310

    Office

    $174.73

    Facility

    $147.49

    $7.04 higher than Redding for the office setting.

  • Rest Of California

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99310

    Office

    $170.01

    Facility

    $144.75

    $2.32 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99310

    Office

    $173.68

    Facility

    $146.87

    $5.99 higher than Redding for the office setting.

  • Salinas

    California · 99310

    Office

    $172.96

    Facility

    $146.25

    $5.27 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99310

    Office

    $175.23

    Facility

    $147.67

    $7.54 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99310

    Office

    $194.17

    Facility

    $161.67

    $26.48 higher than Redding for the office setting.

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

    California · 99310

    Office

    $193.93

    Facility

    $161.43

    $26.24 higher than Redding for the office setting.

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

    California · 99310

    Office

    $198.12

    Facility

    $164.88

    $30.43 higher than Redding for the office setting.

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

    California · 99310

    Office

    $197.14

    Facility

    $163.91

    $29.45 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99310

    Office

    $170.39

    Facility

    $144.14

    $2.70 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 99310

    Office

    $175.54

    Facility

    $147.54

    $7.85 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 99310

    Office

    $173.12

    Facility

    $146.25

    $5.43 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 99310

    Office

    $177.20

    Facility

    $148.90

    $9.51 higher than Redding for the office setting.

  • Stockton

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 99310

    Office

    $185.40

    Facility

    $155.02

    $17.71 higher than Redding for the office setting.

  • Visalia

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 99310

    Office

    $167.69

    Facility

    $142.43

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99310

    Office

    $180.35

    Facility

    $153.20

    $12.66 higher than Redding for the office setting.

  • Miami

    Florida · 99310

    Office

    $176.63

    Facility

    $152.64

    $8.94 higher than Redding for the office setting.

  • Chicago

    Illinois · 99310

    Office

    $173.38

    Facility

    $150.22

    $5.69 higher than Redding for the office setting.

  • Manhattan

    New York · 99310

    Office

    $183.60

    Facility

    $156.82

    $15.91 higher than Redding for the office setting.

  • Alaska*

    Alaska · 99310

    Office

    $211.02

    Facility

    $186.48

    $43.33 higher than Redding for the office setting.

  • Alabama

    Alabama · 99310

    Office

    $152.44

    Facility

    $132.27

    $15.25 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 99310

    Office

    $151.07

    Facility

    $131.28

    $16.62 lower than Redding for the office setting.

  • Arizona

    Arizona · 99310

    Office

    $160.37

    Facility

    $138.04

    $7.32 lower than Redding for the office setting.

  • Colorado

    Colorado · 99310

    Office

    $166.94

    Facility

    $142.41

    $0.75 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 99310

    Office

    $171.51

    Facility

    $146.69

    $3.82 higher than Redding for the office setting.

  • Delaware

    Delaware · 99310

    Office

    $162.34

    Facility

    $139.57

    $5.35 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 99310

    Office

    $169.81

    Facility

    $146.47

    $2.12 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 99310

    Office

    $164.10

    Facility

    $142.06

    $3.59 lower than Redding for the office setting.

  • Atlanta

    Georgia · 99310

    Office

    $166.03

    Facility

    $142.61

    $1.66 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 99310

    Office

    $157.90

    Facility

    $137.34

    $9.79 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 99310

    Office

    $168.98

    Facility

    $142.78

    $1.29 higher than Redding for the office setting.

  • Iowa

    Iowa · 99310

    Office

    $153.76

    Facility

    $132.68

    $13.93 lower than Redding for the office setting.

  • Idaho

    Idaho · 99310

    Office

    $154.61

    Facility

    $133.41

    $13.08 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 99310

    Office

    $165.42

    Facility

    $144.22

    $2.27 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 99310

    Office

    $161.82

    Facility

    $140.77

    $5.87 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 99310

    Office

    $171.10

    Facility

    $147.43

    $3.41 higher than Redding for the office setting.

  • Indiana

    Indiana · 99310

    Office

    $155.14

    Facility

    $133.78

    $12.55 lower than Redding for the office setting.

  • Kansas

    Kansas · 99310

    Office

    $153.82

    Facility

    $132.99

    $13.87 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 99310

    Office

    $155.76

    Facility

    $135.28

    $11.93 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 99310

    Office

    $160.58

    Facility

    $138.89

    $7.11 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 99310

    Office

    $155.81

    Facility

    $135.42

    $11.88 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 99310

    Office

    $178.58

    Facility

    $151.06

    $10.89 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99310

    Office

    $166.73

    Facility

    $142.46

    $0.96 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99310

    Office

    $171.07

    Facility

    $146.34

    $3.38 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 99310

    Office

    $164.44

    Facility

    $141.12

    $3.25 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 99310

    Office

    $155.66

    Facility

    $134.45

    $12.03 lower than Redding for the office setting.

  • Southern Maine

    Maine · 99310

    Office

    $160.18

    Facility

    $137.34

    $7.51 lower than Redding for the office setting.

  • Detroit

    Michigan · 99310

    Office

    $165.94

    Facility

    $143.70

    $1.75 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 99310

    Office

    $158.77

    Facility

    $137.73

    $8.92 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 99310

    Office

    $160.21

    Facility

    $136.50

    $7.48 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 99310

    Office

    $159.34

    Facility

    $137.70

    $8.35 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 99310

    Office

    $160.33

    Facility

    $138.39

    $7.36 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 99310

    Office

    $154.48

    Facility

    $134.62

    $13.21 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 99310

    Office

    $152.77

    Facility

    $132.93

    $14.92 lower than Redding for the office setting.

  • Montana**

    Montana · 99310

    Office

    $163.32

    Facility

    $140.27

    $4.37 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 99310

    Office

    $156.59

    Facility

    $135.09

    $11.10 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 99310

    Office

    $159.16

    Facility

    $136.12

    $8.53 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 99310

    Office

    $154.13

    Facility

    $132.86

    $13.56 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 99310

    Office

    $165.03

    Facility

    $141.04

    $2.66 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 99310

    Office

    $179.75

    Facility

    $153.01

    $12.06 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 99310

    Office

    $173.53

    Facility

    $148.36

    $5.84 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 99310

    Office

    $159.53

    Facility

    $138.39

    $8.16 lower than Redding for the office setting.

  • Nevada**

    Nevada · 99310

    Office

    $162.22

    Facility

    $139.15

    $5.47 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99310

    Office

    $187.20

    Facility

    $159.79

    $19.51 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99310

    Office

    $174.98

    Facility

    $149.74

    $7.29 higher than Redding for the office setting.

  • Queens

    New York · 99310

    Office

    $183.84

    Facility

    $156.60

    $16.15 higher than Redding for the office setting.

  • Rest Of New York

    New York · 99310

    Office

    $158.11

    Facility

    $136.21

    $9.58 lower than Redding for the office setting.

  • Ohio

    Ohio · 99310

    Office

    $157.92

    Facility

    $136.88

    $9.77 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 99310

    Office

    $155.05

    Facility

    $134.47

    $12.64 lower than Redding for the office setting.

  • Portland

    Oregon · 99310

    Office

    $170.00

    Facility

    $144.40

    $2.31 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 99310

    Office

    $161.00

    Facility

    $138.04

    $6.69 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99310

    Office

    $168.94

    Facility

    $144.95

    $1.25 higher than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99310

    Office

    $157.80

    Facility

    $136.64

    $9.89 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 99310

    Office

    $163.92

    Facility

    $140.62

    $3.77 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 99310

    Office

    $166.42

    Facility

    $142.61

    $1.27 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 99310

    Office

    $157.51

    Facility

    $136.21

    $10.18 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 99310

    Office

    $158.67

    Facility

    $135.63

    $9.02 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 99310

    Office

    $154.37

    Facility

    $133.42

    $13.32 lower than Redding for the office setting.

  • Austin

    Texas · 99310

    Office

    $166.36

    Facility

    $141.98

    $1.33 lower than Redding for the office setting.

  • Beaumont

    Texas · 99310

    Office

    $157.18

    Facility

    $136.21

    $10.51 lower than Redding for the office setting.

  • Brazoria

    Texas · 99310

    Office

    $161.97

    Facility

    $139.13

    $5.72 lower than Redding for the office setting.

  • Dallas

    Texas · 99310

    Office

    $162.92

    Facility

    $139.97

    $4.77 lower than Redding for the office setting.

  • Fort Worth

    Texas · 99310

    Office

    $162.39

    Facility

    $139.66

    $5.30 lower than Redding for the office setting.

  • Galveston

    Texas · 99310

    Office

    $162.43

    Facility

    $139.55

    $5.26 lower than Redding for the office setting.

  • Houston

    Texas · 99310

    Office

    $166.28

    Facility

    $143.39

    $1.41 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 99310

    Office

    $159.45

    Facility

    $137.58

    $8.24 lower than Redding for the office setting.

  • Utah

    Utah · 99310

    Office

    $158.85

    Facility

    $137.18

    $8.84 lower than Redding for the office setting.

  • Virginia

    Virginia · 99310

    Office

    $160.20

    Facility

    $137.55

    $7.49 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99310

    Office

    $163.92

    Facility

    $140.62

    $3.77 lower than Redding for the office setting.

  • Vermont

    Vermont · 99310

    Office

    $159.24

    Facility

    $136.42

    $8.45 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 99310

    Office

    $166.20

    Facility

    $141.93

    $1.49 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 99310

    Office

    $180.98

    Facility

    $152.70

    $13.29 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 99310

    Office

    $155.84

    Facility

    $133.76

    $11.85 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 99310

    Office

    $158.13

    Facility

    $138.10

    $9.56 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 99310

    Office

    $161.51

    Facility

    $138.46

    $6.18 lower than Redding for the office setting.

See how rates vary across the country

99310 · 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.

$151.07

$211.02

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$211.021
AL$152.441
AR$151.071
AZ$160.371
CA$167.69–$198.1229
CO$166.941
CT$171.511
DC$180.351
DE$162.341
FL$164.10–$176.633
GA$157.90–$166.032
GU$168.981
HI$168.981
IA$153.761
ID$154.611
IL$161.82–$173.384
IN$155.141
KS$153.821
KY$155.761
LA$155.81–$160.582
MA$166.73–$178.582
MD$164.44–$180.353
ME$155.66–$160.182
MI$158.77–$165.942
MN$160.211
MO$154.48–$160.333
MS$152.771
MT$163.321
NC$156.591
ND$159.161
NE$154.131
NH$165.031
NJ$173.53–$179.752
NM$159.531
NV$162.221
NY$158.11–$187.205
OH$157.921
OK$155.051
OR$161.00–$170.002
PA$157.80–$168.942
PR$163.921
RI$166.421
SC$157.511
SD$158.671
TN$154.371
TX$157.18–$166.368
UT$158.851
VA$160.20–$180.352
VI$163.921
VT$159.241
WA$166.20–$180.982
WI$155.841
WV$158.131
WY$161.511

Explore 99310 on the national rate map →

Where does this rate apply?

Redding is a Medicare payment area. Our Census mapping connects it to 32 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 99310 in Redding, the physician’s office rate is $167.69 and the facility-setting rate is $142.43: a difference of $25.26.

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 99310 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$184.46

$167.69 × 110% = $184.46

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.

Compare your contract offer →

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 99310 in Redding.

PPRRVU2026_Oct_nonQPP.csv

13,051

Code
99310
Physician work
2.80
Practice expense
1.88
Malpractice
0.21

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 99310 in Redding
ComponentRVULocality factorAdjusted
Physician work2.80× 1.0172.8476
Practice expense1.88× 1.0962.0605
Malpractice0.21× 0.5360.1126
Total RVUs5.0206
Conversion factor× 33.4009

Office / nonfacility rate, Redding$167.69

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

Open 99310 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.81.017
Practice expense1.881.096
Malpractice0.210.536

(2.8 × 1.017 + 1.88 × 1.096 + 0.21 × 0.536) × $33.4009 = $167.69

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.81.017
Practice expense1.191.096
Malpractice0.210.536

(2.8 × 1.017 + 1.19 × 1.096 + 0.21 × 0.536) × $33.4009 = $142.43

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

99310 · Office / nonfacility

$167.69

Effective 2026-10-01

The base rate is $16.01 higher than on 2025-10-01, moving from $151.68 to $167.69 (10.6%).

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

    $151.68changed to$167.69

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.59 changed to 1.88
    • Malpractice RVU 0.20 changed to 0.21
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $151.68

    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$167.69$142.43RVU26D
2026-07-01$167.69$142.43RVU26C
2026-04-01$167.69$142.43RVU26B
2026-01-01$167.69$142.43RVU26A
2025-10-01$151.68$151.68RVU25D
2025-07-01$151.68$151.68RVU25C
2025-04-01$151.68$151.68RVU25B
2025-01-01$151.68$151.68RVU25A

99310 billing questions

How do I decide between 99309 and 99310?

Use 99310 for high MDM or at least 45 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes when 99310's criteria are not met; a hospitalization decision can support high management risk but does not, by itself, establish high MDM.

Can 99310 be reported for a resident's first visit by our group?

Choose the code based on the service performed, not simply whether the resident is new to the group. Initial nursing facility codes 99304-99306 describe an initial evaluation; 99310 describes subsequent care.

What counts toward the 45 minutes?

Count the reporting practitioner's qualifying work on the date of service, such as examining the resident, reviewing records, coordinating care, ordering, and documenting. Exclude facility staff time and time spent on separately reported services.

How is prolonged time billed for Medicare with 99310?

When 99310 is selected by time and Medicare's threshold for prolonged nursing facility care is met, report G0317 for eligible additional 15-minute increments rather than CPT 99418. Document the total qualifying time.

Which place of service is used?

Use POS 31 for a skilled nursing facility stay and POS 32 for a nursing facility. Visits to assisted living residents fall under home or residence visit codes instead.

Can I bill 99310 and a discharge code for the same service?

No. When the service is nursing facility discharge management, report 99315 or 99316 according to the time spent on that service instead of 99310.

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 99310PPRRVU2026_Oct_nonQPP.csv, line 13,051 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet