No office rate
99232 requires moderate medical decision making or at least 35 minutes; 99233 requires high medical decision making or at least 50 minutes. A worsening diagnosis alone does not establish high decision making.
On this page
CMS RVU26D · Effective 2026-10-01
99233 Hospital follow-up visit Medicare reimbursement rates in Georgia
Report a subsequent inpatient or observation hospital visit when medical decision making is high or the practitioner spends at least 50 minutes that date. Compare 99233 office and facility rates across CMS payment localities in Georgia.
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 99233 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$105.80–$108.66
2 of 2 localities have a supported rate.
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 99233: Subsequent hospital inpatient or observation visit, high complexity
Report a subsequent inpatient or observation hospital visit when medical decision making is high or the practitioner spends at least 50 minutes that date.
This subsequent hospital visit is for a patient receiving inpatient or observation care after the initial hospital encounter. A hospitalist, internist, specialist, nurse practitioner, or physician assistant may assess a worsening condition, adjust treatment, and coordinate care. Situations may include worsening sepsis or heart failure that is not responding to diuresis, but the diagnosis alone does not establish the visit level. An intensivist may report this visit when the work does not meet critical care reporting requirements.
Select 99233 using high medical decision making or at least 50 minutes of the reporting practitioner's total time on the calendar date. Qualifying time can include reviewing records, discussing management with other clinicians, counseling family when appropriate, and documenting the visit; exclude time spent on separately reported services. For medical decision making, documentation must support a high level in two of its three elements, such as problems addressed, data, and management risk. Record total time when selecting by time. The same subsequent-care series covers inpatient and observation stays. CMS reports equal office and facility practice expense values for this code, although most reported Medicare services are in facilities.
Where the value comes from
- Work RVU2.40 · 75%
- Practice expense (office) RVU0.62 · 19%
- Malpractice RVU0.18 · 6%
23M
Medicare services in 2024 · #9 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.
99233 compared with similar codes
Office rates for Georgia, from the same CMS release.
No office rate
99223 is high-level initial hospital care; 99233 is high-level subsequent care during the inpatient or observation stay.
No office rate
99236 covers high-level hospital care with admission and discharge on the same date; 99233 covers a subsequent visit during an ongoing stay.
$296.43–$314.79
99291 requires at least 30 minutes of qualifying critical care for a critically ill or injured patient. Use 99233 for a subsequent high-level hospital visit when critical care reporting requirements are not met.
Compare 99233 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.
2 of 2 payment localities
Atlanta →
Office / nonfacility
Unavailable
Facility
$108.66
Rest Of Georgia →
Office / nonfacility
Unavailable
Facility
$105.80
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
99233 billing questions
How do I choose between 99232 and 99233?
99232 requires moderate medical decision making or at least 35 minutes; 99233 requires high medical decision making or at least 50 minutes. For a decision-making selection, two of the three elements must support the chosen level.
Can 99233 be reported for an observation patient?
Yes. Since 2023, subsequent hospital care codes cover both inpatient and observation status; the former separate observation follow-up codes are no longer used.
How is prolonged time reported beyond 99233 for Medicare?
Medicare uses HCPCS G0316 rather than CPT 99418 when 99233 is selected by time and the service meets Medicare's prolonged-service time threshold. Reaching the 50-minute minimum for 99233 alone does not support G0316.
Can I bill 99233 on the day of discharge?
For the practitioner's discharge-day management, report 99238 or 99239 instead of a subsequent hospital visit.
How do consultants bill follow-up visits for Medicare patients?
Medicare does not pay inpatient consultation codes 99252–99255. A consultant uses an appropriate initial hospital care code for the first hospital visit and a subsequent hospital care code, including 99233 when supported, for later visits.
How is a split/shared visit with an NP or PA reported?
For a qualifying facility-based split/shared visit, the physician or NP/PA who performs the substantive portion reports the visit with modifier FS. The substantive portion is more than half of the combined, nonduplicated time or the substantive part of medical decision making under CMS rules.
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.
13,02099223,,1st hosp ip/obs high 75,A,,3.50,0.90,NA,0.90,,0.28,4.68,4.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02199231,,Sbsq hosp ip/obs sf/low 25,A,,1.00,0.24,NA,0.24,,0.08,1.32,1.32,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02299232,,Sbsq hosp ip/obs moderate 35,A,,1.59,0.40,NA,0.40,,0.12,2.11,2.11,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02399233,,Sbsq hosp ip/obs high 50,A,,2.40,0.62,NA,0.62,,0.18,3.20,3.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02499234,,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