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CMS RVU26D · Effective 2026-10-01

99349 in Redding

Office / nonfacility

$135.53

Base rate per service

Facility setting

Not available in this setting

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 99349: Established patient home or residence visit, moderate complexity

Report an established patient home or residence visit when medical decision making is moderate or the reporting practitioner spends at least 40 minutes on the visit date.

This visit covers evaluation and management of an established patient in a private home or another residence, such as an assisted living facility or group home, rather than a nursing facility. Physicians, nurse practitioners, and physician assistants commonly perform these visits in house-call and home-based primary care programs. Patients may have limited mobility and several chronic conditions, such as heart failure, diabetes, or COPD, requiring assessment of a worsening problem or a medication change.

Select this level by moderate medical decision making or at least 40 minutes of the reporting practitioner’s qualifying time on the visit date. For decision making, document the problems addressed, relevant data reviewed, and management risk; two of those three elements must support the level. For time-based selection, record total minutes, including qualifying non-face-to-face work that day but excluding travel, staff time, and separately billed services. The former domiciliary and rest home visit settings are included in this home or residence visit family. Report the place of service that identifies where the patient was seen.

Where the value comes from

  • Work RVU2.44 · 62%
  • Practice expense (office) RVU1.36 · 34%
  • Malpractice RVU0.16 · 4%

3.7M

Medicare services in 2024 · #51 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.

99349 compared with similar codes

Office rates for Redding, from the same CMS release.

99348

Home visit

Established patient, low MDM or 30 minutes

$81.13

99348 is the low-decision-making established patient home visit, with a 30-minute minimum when selected by time. Choose 99349 for moderate decision making, supported by two of its three elements, or at least 40 minutes.

99350

Home visit

Established patient, high complexity

$197.60

99350 requires high medical decision making or at least 60 minutes of qualifying time. Choose 99349 when decision making is moderate or its 40-minute time threshold is met without reaching the higher time threshold.

99344

Home visit

New patient, moderate complexity

$150.14

99344 is a moderate-decision-making home visit for a new patient, with a 60-minute minimum when selected by time. Use 99349 when the patient is established and its decision-making or time requirement is met.

99214

Office visit

Established patient, moderate complexity

$140.94

99214 is the moderate-level established patient visit in an office or other outpatient setting. For an established patient seen at home or in another qualifying residence, select from the home or residence visit family.

The same code, a different location

How does Redding compare?

In Bakersfield, the office rate for 99349 is $136.09—$0.56 higher than the $135.53 rate in Redding. Both use the same code, release and participation basis.

99349 across payment areas

Same release and payment basis · bars start at $0

  1. Redding · This locality

    $135.53

  2. $0.56 higher than Redding

  3. Chico

    $135.53

    The same base rate than Redding

  4. El Centro

    $135.56

    $0.03 higher than Redding

  5. Fresno

    $135.53

    The same base rate than Redding

  6. The same base rate than Redding

  7. $6.60 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, 99349 ranges from $123.27 in Arkansas to $173.57 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 · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Merced

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Modesto

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Napa

    California · 99349

    Office

    $149.22

    Facility

    Unavailable

    $13.69 higher than Redding for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 99349

    Office

    $140.80

    Facility

    Unavailable

    $5.27 higher than Redding for the office setting.

  • Rest Of California

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 99349

    Office

    $137.31

    Facility

    Unavailable

    $1.78 higher than Redding for the office setting.

  • Sacramento-Roseville-Folsom

    California · 99349

    Office

    $140.13

    Facility

    Unavailable

    $4.60 higher than Redding for the office setting.

  • Salinas

    California · 99349

    Office

    $139.54

    Facility

    Unavailable

    $4.01 higher than Redding for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 99349

    Office

    $141.17

    Facility

    Unavailable

    $5.64 higher than Redding for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 99349

    Office

    $155.74

    Facility

    Unavailable

    $20.21 higher than Redding for the office setting.

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

    California · 99349

    Office

    $155.56

    Facility

    Unavailable

    $20.03 higher than Redding for the office setting.

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

    California · 99349

    Office

    $158.83

    Facility

    Unavailable

    $23.30 higher than Redding for the office setting.

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

    California · 99349

    Office

    $158.09

    Facility

    Unavailable

    $22.56 higher than Redding for the office setting.

  • San Luis Obispo-Paso Robles

    California · 99349

    Office

    $137.49

    Facility

    Unavailable

    $1.96 higher than Redding for the office setting.

  • Santa Cruz-Watsonville

    California · 99349

    Office

    $141.27

    Facility

    Unavailable

    $5.74 higher than Redding for the office setting.

  • Santa Maria-Santa Barbara

    California · 99349

    Office

    $139.61

    Facility

    Unavailable

    $4.08 higher than Redding for the office setting.

  • Santa Rosa-Petaluma

    California · 99349

    Office

    $142.59

    Facility

    Unavailable

    $7.06 higher than Redding for the office setting.

  • Stockton

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Vallejo

    California · 99349

    Office

    $148.96

    Facility

    Unavailable

    $13.43 higher than Redding for the office setting.

  • Visalia

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Yuba City

    California · 99349

    Office

    $135.53

    Facility

    Unavailable

    The same base rate than Redding for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 99349

    Office

    $145.36

    Facility

    Unavailable

    $9.83 higher than Redding for the office setting.

  • Miami

    Florida · 99349

    Office

    $142.30

    Facility

    Unavailable

    $6.77 higher than Redding for the office setting.

  • Chicago

    Illinois · 99349

    Office

    $139.99

    Facility

    Unavailable

    $4.46 higher than Redding for the office setting.

  • Manhattan

    New York · 99349

    Office

    $147.97

    Facility

    Unavailable

    $12.44 higher than Redding for the office setting.

  • Alaska*

    Alaska · 99349

    Office

    $173.57

    Facility

    Unavailable

    $38.04 higher than Redding for the office setting.

  • Alabama

    Alabama · 99349

    Office

    $124.27

    Facility

    Unavailable

    $11.26 lower than Redding for the office setting.

  • Arkansas

    Arkansas · 99349

    Office

    $123.27

    Facility

    Unavailable

    $12.26 lower than Redding for the office setting.

  • Arizona

    Arizona · 99349

    Office

    $130.09

    Facility

    Unavailable

    $5.44 lower than Redding for the office setting.

  • Colorado

    Colorado · 99349

    Office

    $134.98

    Facility

    Unavailable

    $0.55 lower than Redding for the office setting.

  • Connecticut

    Connecticut · 99349

    Office

    $138.52

    Facility

    Unavailable

    $2.99 higher than Redding for the office setting.

  • Delaware

    Delaware · 99349

    Office

    $131.59

    Facility

    Unavailable

    $3.94 lower than Redding for the office setting.

  • Fort Lauderdale

    Florida · 99349

    Office

    $137.18

    Facility

    Unavailable

    $1.65 higher than Redding for the office setting.

  • Rest Of Florida

    Florida · 99349

    Office

    $132.96

    Facility

    Unavailable

    $2.57 lower than Redding for the office setting.

  • Atlanta

    Georgia · 99349

    Office

    $134.31

    Facility

    Unavailable

    $1.22 lower than Redding for the office setting.

  • Rest Of Georgia

    Georgia · 99349

    Office

    $128.39

    Facility

    Unavailable

    $7.14 lower than Redding for the office setting.

  • Hawaii, Guam

    Hawaii · 99349

    Office

    $136.24

    Facility

    Unavailable

    $0.71 higher than Redding for the office setting.

  • Iowa

    Iowa · 99349

    Office

    $125.18

    Facility

    Unavailable

    $10.35 lower than Redding for the office setting.

  • Idaho

    Idaho · 99349

    Office

    $125.82

    Facility

    Unavailable

    $9.71 lower than Redding for the office setting.

  • East St. Louis

    Illinois · 99349

    Office

    $134.05

    Facility

    Unavailable

    $1.48 lower than Redding for the office setting.

  • Rest Of Illinois

    Illinois · 99349

    Office

    $131.32

    Facility

    Unavailable

    $4.21 lower than Redding for the office setting.

  • Suburban Chicago

    Illinois · 99349

    Office

    $138.19

    Facility

    Unavailable

    $2.66 higher than Redding for the office setting.

  • Indiana

    Indiana · 99349

    Office

    $126.20

    Facility

    Unavailable

    $9.33 lower than Redding for the office setting.

  • Kansas

    Kansas · 99349

    Office

    $125.26

    Facility

    Unavailable

    $10.27 lower than Redding for the office setting.

  • Kentucky

    Kentucky · 99349

    Office

    $126.77

    Facility

    Unavailable

    $8.76 lower than Redding for the office setting.

  • New Orleans

    Louisiana · 99349

    Office

    $130.31

    Facility

    Unavailable

    $5.22 lower than Redding for the office setting.

  • Rest Of Louisiana

    Louisiana · 99349

    Office

    $126.82

    Facility

    Unavailable

    $8.71 lower than Redding for the office setting.

  • Metropolitan Boston

    Massachusetts · 99349

    Office

    $143.83

    Facility

    Unavailable

    $8.30 higher than Redding for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 99349

    Office

    $134.89

    Facility

    Unavailable

    $0.64 lower than Redding for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 99349

    Office

    $138.15

    Facility

    Unavailable

    $2.62 higher than Redding for the office setting.

  • Rest Of Maryland

    Maryland · 99349

    Office

    $133.19

    Facility

    Unavailable

    $2.34 lower than Redding for the office setting.

  • Rest Of Maine

    Maine · 99349

    Office

    $126.61

    Facility

    Unavailable

    $8.92 lower than Redding for the office setting.

  • Southern Maine

    Maine · 99349

    Office

    $129.89

    Facility

    Unavailable

    $5.64 lower than Redding for the office setting.

  • Detroit

    Michigan · 99349

    Office

    $134.34

    Facility

    Unavailable

    $1.19 lower than Redding for the office setting.

  • Rest Of Michigan

    Michigan · 99349

    Office

    $129.00

    Facility

    Unavailable

    $6.53 lower than Redding for the office setting.

  • Minnesota

    Minnesota · 99349

    Office

    $129.82

    Facility

    Unavailable

    $5.71 lower than Redding for the office setting.

  • Metropolitan Kansas City

    Missouri · 99349

    Office

    $129.37

    Facility

    Unavailable

    $6.16 lower than Redding for the office setting.

  • Metropolitan St. Louis

    Missouri · 99349

    Office

    $130.10

    Facility

    Unavailable

    $5.43 lower than Redding for the office setting.

  • Rest Of Missouri

    Missouri · 99349

    Office

    $125.86

    Facility

    Unavailable

    $9.67 lower than Redding for the office setting.

  • Mississippi

    Mississippi · 99349

    Office

    $124.56

    Facility

    Unavailable

    $10.97 lower than Redding for the office setting.

  • Montana**

    Montana · 99349

    Office

    $132.26

    Facility

    Unavailable

    $3.27 lower than Redding for the office setting.

  • North Carolina

    North Carolina · 99349

    Office

    $127.29

    Facility

    Unavailable

    $8.24 lower than Redding for the office setting.

  • North Dakota**

    North Dakota · 99349

    Office

    $129.09

    Facility

    Unavailable

    $6.44 lower than Redding for the office setting.

  • Nebraska

    Nebraska · 99349

    Office

    $125.45

    Facility

    Unavailable

    $10.08 lower than Redding for the office setting.

  • New Hampshire

    New Hampshire · 99349

    Office

    $133.46

    Facility

    Unavailable

    $2.07 lower than Redding for the office setting.

  • Northern Nj

    New Jersey · 99349

    Office

    $145.03

    Facility

    Unavailable

    $9.50 higher than Redding for the office setting.

  • Rest Of New Jersey

    New Jersey · 99349

    Office

    $140.22

    Facility

    Unavailable

    $4.69 higher than Redding for the office setting.

  • New Mexico

    New Mexico · 99349

    Office

    $129.57

    Facility

    Unavailable

    $5.96 lower than Redding for the office setting.

  • Nevada**

    Nevada · 99349

    Office

    $131.42

    Facility

    Unavailable

    $4.11 lower than Redding for the office setting.

  • Nyc Suburbs/Long Island

    New York · 99349

    Office

    $150.65

    Facility

    Unavailable

    $15.12 higher than Redding for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 99349

    Office

    $141.37

    Facility

    Unavailable

    $5.84 higher than Redding for the office setting.

  • Queens

    New York · 99349

    Office

    $148.11

    Facility

    Unavailable

    $12.58 higher than Redding for the office setting.

  • Rest Of New York

    New York · 99349

    Office

    $128.41

    Facility

    Unavailable

    $7.12 lower than Redding for the office setting.

  • Ohio

    Ohio · 99349

    Office

    $128.36

    Facility

    Unavailable

    $7.17 lower than Redding for the office setting.

  • Oklahoma

    Oklahoma · 99349

    Office

    $126.22

    Facility

    Unavailable

    $9.31 lower than Redding for the office setting.

  • Portland

    Oregon · 99349

    Office

    $137.25

    Facility

    Unavailable

    $1.72 higher than Redding for the office setting.

  • Rest Of Oregon

    Oregon · 99349

    Office

    $130.50

    Facility

    Unavailable

    $5.03 lower than Redding for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 99349

    Office

    $136.63

    Facility

    Unavailable

    $1.10 higher than Redding for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 99349

    Office

    $128.25

    Facility

    Unavailable

    $7.28 lower than Redding for the office setting.

  • Puerto Rico

    Puerto Rico · 99349

    Office

    $132.69

    Facility

    Unavailable

    $2.84 lower than Redding for the office setting.

  • Rhode Island

    Rhode Island · 99349

    Office

    $134.74

    Facility

    Unavailable

    $0.79 lower than Redding for the office setting.

  • South Carolina

    South Carolina · 99349

    Office

    $128.01

    Facility

    Unavailable

    $7.52 lower than Redding for the office setting.

  • South Dakota**

    South Dakota · 99349

    Office

    $128.72

    Facility

    Unavailable

    $6.81 lower than Redding for the office setting.

  • Tennessee

    Tennessee · 99349

    Office

    $125.66

    Facility

    Unavailable

    $9.87 lower than Redding for the office setting.

  • Austin

    Texas · 99349

    Office

    $134.46

    Facility

    Unavailable

    $1.07 lower than Redding for the office setting.

  • Beaumont

    Texas · 99349

    Office

    $127.80

    Facility

    Unavailable

    $7.73 lower than Redding for the office setting.

  • Brazoria

    Texas · 99349

    Office

    $131.34

    Facility

    Unavailable

    $4.19 lower than Redding for the office setting.

  • Dallas

    Texas · 99349

    Office

    $132.06

    Facility

    Unavailable

    $3.47 lower than Redding for the office setting.

  • Fort Worth

    Texas · 99349

    Office

    $131.68

    Facility

    Unavailable

    $3.85 lower than Redding for the office setting.

  • Galveston

    Texas · 99349

    Office

    $131.68

    Facility

    Unavailable

    $3.85 lower than Redding for the office setting.

  • Houston

    Texas · 99349

    Office

    $134.61

    Facility

    Unavailable

    $0.92 lower than Redding for the office setting.

  • Rest Of Texas

    Texas · 99349

    Office

    $129.43

    Facility

    Unavailable

    $6.10 lower than Redding for the office setting.

  • Utah

    Utah · 99349

    Office

    $129.00

    Facility

    Unavailable

    $6.53 lower than Redding for the office setting.

  • Virginia

    Virginia · 99349

    Office

    $129.92

    Facility

    Unavailable

    $5.61 lower than Redding for the office setting.

  • Virgin Islands

    United States Virgin Islands · 99349

    Office

    $132.69

    Facility

    Unavailable

    $2.84 lower than Redding for the office setting.

  • Vermont

    Vermont · 99349

    Office

    $129.17

    Facility

    Unavailable

    $6.36 lower than Redding for the office setting.

  • Rest Of Washington

    Washington · 99349

    Office

    $134.46

    Facility

    Unavailable

    $1.07 lower than Redding for the office setting.

  • Seattle (King Cnty)

    Washington · 99349

    Office

    $145.68

    Facility

    Unavailable

    $10.15 higher than Redding for the office setting.

  • Wisconsin

    Wisconsin · 99349

    Office

    $126.66

    Facility

    Unavailable

    $8.87 lower than Redding for the office setting.

  • West Virginia

    West Virginia · 99349

    Office

    $128.62

    Facility

    Unavailable

    $6.91 lower than Redding for the office setting.

  • Wyoming**

    Wyoming · 99349

    Office

    $130.88

    Facility

    Unavailable

    $4.65 lower than Redding for the office setting.

See how rates vary across the country

99349 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$123.27

$173.57

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$173.571
AL$124.271
AR$123.271
AZ$130.091
CA$135.53–$158.8329
CO$134.981
CT$138.521
DC$145.361
DE$131.591
FL$132.96–$142.303
GA$128.39–$134.312
GU$136.241
HI$136.241
IA$125.181
ID$125.821
IL$131.32–$139.994
IN$126.201
KS$125.261
KY$126.771
LA$126.82–$130.312
MA$134.89–$143.832
MD$133.19–$145.363
ME$126.61–$129.892
MI$129.00–$134.342
MN$129.821
MO$125.86–$130.103
MS$124.561
MT$132.261
NC$127.291
ND$129.091
NE$125.451
NH$133.461
NJ$140.22–$145.032
NM$129.571
NV$131.421
NY$128.41–$150.655
OH$128.361
OK$126.221
OR$130.50–$137.252
PA$128.25–$136.632
PR$132.691
RI$134.741
SC$128.011
SD$128.721
TN$125.661
TX$127.80–$134.618
UT$129.001
VA$129.92–$145.362
VI$132.691
VT$129.171
WA$134.46–$145.682
WI$126.661
WV$128.621
WY$130.881

Explore 99349 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.

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 99349 in Redding. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$149.08

$135.53 × 110% = $149.08

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 99349 in Redding.

PPRRVU2026_Oct_nonQPP.csv

13,060

Code
99349
Physician work
2.44
Practice expense
1.36
Malpractice
0.16

GPCI2026.csv

19

Locality
Redding
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 99349 in Redding
ComponentRVULocality factorAdjusted
Physician work2.44× 1.0172.4815
Practice expense1.36× 1.0961.4906
Malpractice0.16× 0.5360.0858
Total RVUs4.0578
Conversion factor× 33.4009

Office / nonfacility rate, Redding$135.53

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

Open 99349 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.441.017
Practice expense1.361.096
Malpractice0.160.536

(2.44 × 1.017 + 1.36 × 1.096 + 0.16 × 0.536) × $33.4009 = $135.53

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

99349 · Office / nonfacility

$135.53

Effective 2026-10-01

The base rate is $10.53 higher than on 2025-10-01, moving from $125.00 to $135.53 (8.4%).

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

    $125.00changed to$135.53

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 1.19 changed to 1.36
    • 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: $125.00

    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$135.53Not available in this settingRVU26D
2026-07-01$135.53Not available in this settingRVU26C
2026-04-01$135.53Not available in this settingRVU26B
2026-01-01$135.53Not available in this settingRVU26A
2025-10-01$125.00Not available in this settingRVU25D
2025-07-01$125.00Not available in this settingRVU25C
2025-04-01$125.00Not available in this settingRVU25B
2025-01-01$125.00Not available in this settingRVU25A

99349 billing questions

When is 99349 chosen over 99348 or 99350?

Choose 99349 for moderate medical decision making or at least 40 minutes of qualifying practitioner time. When selecting by time, 99348 has a 30-minute minimum and 99350 has a 60-minute minimum; choose the highest level whose minimum is met.

Can 99349 be billed for visits in an assisted living facility?

Yes. Assisted living facilities and group homes are residential settings covered by the home or residence visit family. Use the place-of-service code for the actual setting.

Does Medicare require the patient to be homebound for 99349?

No. A medically necessary practitioner visit may be reported even if the patient is not homebound; homebound status concerns eligibility for home health services.

What counts toward the 40-minute threshold?

Count the reporting practitioner’s qualifying work on the visit date, including the visit, record review, care-related caregiver discussion, ordering, and documentation. Exclude travel, staff time, and time spent on separately billed services.

Can prolonged services be added to 99349?

Prolonged home or residence E/M services pair with the highest visit levels, 99345 and 99350, rather than 99349. A visit selected by time reaches 99350 at 60 minutes.

Is a new patient seen at home reported with 99349?

No. For a patient new to the practitioner and same-specialty, same-subspecialty group under the three-year new-patient rule, select from the new-patient home or residence codes, such as 99344 for moderate medical decision making.

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 99349PPRRVU2026_Oct_nonQPP.csv, line 13,060 (RVU26D)
Geographic factors for ReddingGPCI2026.csv, line 19 (RVU26D)