$44.21
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.
On this page
CMS RVU26D · Effective 2026-10-01
99348 Home visit Medicare reimbursement rates in Idaho
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. Compare 99348 office and facility rates across CMS payment localities in Idaho.
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 99348 in Idaho?
Idaho 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
$75.48
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
Facility setting
No 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 99348: Established patient home or residence visit, low complexity
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.
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.
Where the value comes from
- Work RVU1.50 · 64%
- Practice expense (office) RVU0.79 · 33%
- Malpractice RVU0.07 · 3%
1.8M
Medicare services in 2024 · #88 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.
99348 compared with similar codes
Office rates for Idaho, from the same CMS release.
$125.82
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.
$75.88
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.
$74.80
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.
Compare 99348 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
Idaho →
Office / nonfacility
$75.48
Facility
Unavailable
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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 99348 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
13,059
- Code
- 99348
- Physician work
- 1.50
- Practice expense
- 0.79
- Malpractice
- 0.07
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.50 | × 1.000 | 1.5000 |
| Practice expense | 0.79 | × 0.920 | 0.7268 |
| Malpractice | 0.07 | × 0.473 | 0.0331 |
| Total RVUs | 2.2599 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Idaho$75.48
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.5 | 1 |
| Practice expense | 0.79 | 0.92 |
| Malpractice | 0.07 | 0.473 |
(1.5 × 1 + 0.79 × 0.92 + 0.07 × 0.473) × $33.4009 = $75.48
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.
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 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.
13,05699344,,Home/res vst new mod mdm 60,A,,2.87,1.36,,1.36,NA,0.16,4.39,4.39,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05799345,,Home/res vst new high mdm 75,A,,3.88,2.16,,2.16,NA,0.25,6.29,6.29,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05899347,,Home/res vst est sf mdm 20,A,,0.90,0.44,,0.44,NA,0.04,1.38,1.38,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05999348,,Home/res vst est low mdm 30,A,,1.50,0.79,,0.79,NA,0.07,2.36,2.36,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,06099349,,Home/res vst est mod mdm 40,A,,2.44,1.36,,1.36,NA,0.16,3.96,3.96,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,06199350,,Home/res vst est high mdm 60,A,,3.60,1.94,,1.94,NA,0.24,5.78,5.78,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,06299358,,Prolong service w/o contact,I,+,1.80,0.84,,0.39,,0.11,2.75,2.30,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772