Billing code 99348: Home visitMedicare rate & RVUs in Guam
Home or residence E/M visit for an established patient, selected by low medical decision making or at least 30 minutes of practitioner time that day.
Medicare pays $81.46 for 99348 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 99348 covers
This visit covers an established patient seen where they live: a private home, apartment, assisted living facility, group home, or another residence outside a skilled nursing or nursing facility. Physicians, nurse practitioners, and physician assistants in house-call, home-based primary care, and geriatric practices typically report it. They may assess an uncomplicated acute illness, review pertinent information, and discuss a low-risk treatment plan with the patient or caregiver. The diagnosis alone does not establish the visit level.
Select 99348 when at least two of the three medical decision-making elements—problems, data, and risk—support low MDM, or when total practitioner time on the visit date reaches at least 30 minutes. If a higher time threshold is met, select the level supported by that time instead. Travel to and from the residence does not count. Documentation should identify the residence setting, clinically appropriate history and exam, problems addressed, pertinent data, and management plan, or support the time reported. Medicare does not require the patient to be homebound for a practitioner home visit. The place of service code identifies the residence type.
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.
99348 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $81.46 | Unavailable |
How the 99348 rate is calculated
Each of 99348’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 99348
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.50Practice expense 0.79Malpractice 0.07
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 99348
99348 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 99348
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$78.83
Only one setting is priced for this code.
99348 compared with similar codes
Compare codes
99348 vs 99347 vs 99349 vs 99342 vs 99308: national Medicare rates
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How to choose
- 99347Home visit
- 99347 fits straightforward MDM or at least 20 minutes. Choose 99348 for low MDM supported by two qualifying elements or at least 30 minutes when selecting by time.
- 99349Home visit
- 99349 requires moderate MDM or at least 40 minutes. Two stable chronic illnesses or prescription drug management each support one moderate MDM element; a second moderate element is needed to select 99349 by MDM.
- 99342Home visit
- 99342 has the same low-MDM level and 30-minute minimum but is for new patients under the three-year rule for practitioners of the same specialty and subspecialty in the same group.
- 99308Nursing facility visit
- 99308 applies to a subsequent visit for a patient in a skilled nursing or nursing facility. 99348 applies to homes, assisted living, and other non-nursing-facility residences.
99348 billing questions
When should 99348 be chosen over 99349?
Choose 99348 for low MDM or at least 30 minutes when selecting by time. Choose 99349 for moderate MDM or at least 40 minutes; moderate MDM requires two qualifying moderate elements.
Can this code be used for patients living in assisted living facilities?
Yes. Visits in assisted living, group homes, and similar residences are reported with the home or residence E/M series, using the appropriate place of service.
Does travel time count toward the 30 minutes?
No. Count the reporting practitioner's qualifying time spent on the patient's care on the visit date, such as reviewing records, examining, counseling, ordering, and documenting. Exclude time driving to or from the residence.
Can 99348 be reported for a resident of a skilled nursing or nursing facility?
No. Use the appropriate nursing facility E/M code, such as a subsequent nursing facility visit code from 99307-99310, rather than the home or residence series.
What makes a patient established for this code?
The patient received professional services within the past three years from the same practitioner or another practitioner of the same specialty and subspecialty in the same group. Otherwise, consider a new-patient home visit code such as 99342 when its level criteria are met.
What documentation supports low medical decision making?
Document the problems addressed, any data reviewed or analyzed, and management decisions so that at least two of the three MDM elements support the low level. A diagnosis by itself does not establish low MDM.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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