No office rate
Both report hospital inpatient or observation discharge management. Use 99239 when documented discharge-date time exceeds 30 minutes; use 99238 for 30 minutes or less, or when time is not documented.
On this page
CMS RVU26D · Effective 2026-10-01
99238 Hospital discharge Medicare reimbursement rates in Connecticut
Report hospital inpatient or observation discharge management on a date after admission when the discharging physician or qualified health care professional spends 30 minutes or less. Compare 99238 office and facility rates across CMS payment localities in Connecticut.
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.
What does Medicare pay for 99238 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$78.26
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Evaluation and management
About 99238: Hospital inpatient or observation discharge, 30 minutes or less
Report hospital inpatient or observation discharge management on a date after admission when the discharging physician or qualified health care professional spends 30 minutes or less.
This service covers management of a hospital inpatient or observation discharge on a calendar date after admission. The discharging physician or qualified health care professional may perform a final evaluation, discuss the hospital course and continuing care with the patient or caregivers, reconcile medications, prepare prescriptions and referrals, arrange follow-up, and complete discharge records. Hospitalists and other practitioners responsible for the stay commonly perform this work in the hospital.
Choose 99238 when discharge management takes 30 minutes or less; use 99239 when documented discharge-date time exceeds 30 minutes. Count discharge work performed throughout that date, including preparation of the summary, even when the work is not continuous. If time is not documented, report 99238 rather than the higher-time code. The practitioner responsible for discharge reports one discharge management service; other practitioners who provide medically necessary visits select subsequent hospital inpatient or observation care as appropriate. The record should identify the discharge date and support the evaluation, instructions, medications, and follow-up arrangements.
Where the value comes from
- Work RVU1.50 · 67%
- Practice expense (office) RVU0.62 · 28%
- Malpractice RVU0.12 · 5%
1.7M
Medicare services in 2024 · #95 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.
99238 compared with similar codes
Office rates for Connecticut, from the same CMS release.
No office rate
99234 combines admission and discharge care on the same calendar date and may be used for a qualifying Medicare stay of at least eight hours. Use 99238 when discharge occurs on a later calendar date.
No office rate
99232 reports a moderate-level subsequent hospital inpatient or observation visit selected by MDM or time. 99238 is for the practitioner managing the discharge.
$89.99
99315 reports discharge management for a nursing facility resident; 99238 reports discharge management for a hospital inpatient or observation patient.
Compare 99238 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
Unavailable
Facility
$78.26
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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 99238 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
13,027
- Code
- 99238
- Physician work
- 1.50
- Practice expense
- 0.62
- Malpractice
- 0.12
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.50 | × 1.020 | 1.5300 |
| Practice expense | 0.62 | × 1.077 | 0.6677 |
| Malpractice | 0.12 | × 1.210 | 0.1452 |
| Total RVUs | 2.3429 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$78.26
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.5 | 1.02 |
| Practice expense | 0.62 | 1.077 |
| Malpractice | 0.12 | 1.21 |
(1.5 × 1.02 + 0.62 × 1.077 + 0.12 × 1.21) × $33.4009 = $78.26
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.
99238 billing questions
How do I choose between 99238 and 99239?
Use total discharge management time on the discharge date. Report 99238 for 30 minutes or less, or when time is not documented; 99239 requires documented time exceeding 30 minutes.
Does 99238 apply to observation discharges?
Yes. Hospital inpatient and observation discharge management share this code family.
Can I bill 99238 if the patient was admitted and discharged on the same date?
No. For Medicare, a same-date stay of at least eight hours is reported with 99234–99236; a shorter stay is reported with an initial hospital inpatient or observation care code.
What do other physicians bill on the discharge date?
The practitioner managing the discharge reports 99238 or 99239. Another practitioner who provides a medically necessary visit may report an appropriate subsequent hospital inpatient or observation care code, such as 99231–99233.
Does time spent preparing discharge records count?
Yes. Count discharge management work performed on the discharge date, including preparation of the discharge summary, prescriptions, and referral forms, even when that work is not continuous.
What documentation supports 99238?
Document the discharge date and the work performed, such as the final evaluation, continuing-care instructions, medications, and follow-up arrangements. Document total time when using time to distinguish 99238 from 99239.
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.
13,02499234,,Hosp ip/obs sm dt sf/low 45,A,,2.00,0.46,NA,0.46,,0.18,2.64,2.64,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02599235,,Hosp ip/obs same date mod 70,A,,3.24,0.79,NA,0.79,,0.25,4.28,4.28,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02699236,,Hosp ip/obs same date hi 85,A,,4.30,1.02,NA,1.02,,0.36,5.68,5.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02799238,,Hosp ip/obs dschrg mgmt 30/<,A,,1.50,0.62,NA,0.62,,0.12,2.24,2.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02899239,,Hosp ip/obs dschrg mgmt >30,A,,2.15,0.88,NA,0.88,,0.16,3.19,3.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02999242,,Off/op consltj new/est sf 20,I,+,1.08,1.10,,0.51,,0.07,2.25,1.66,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
13,03099243,,Off/op cnsltj new/est low 30,I,+,1.80,1.46,,0.71,,0.11,3.37,2.62,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808