CPT code 99239: Hospital discharge day2026 Medicare rate & RVUs in Illinois
Discharge day management for a hospital inpatient or observation patient when the responsible physician or qualified practitioner spends more than 30 minutes on discharge work that day.
CMS doesn’t publish an office rate for 99239 in Illinois.
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 99239 covers
This service covers the responsible clinician’s work on the day a patient leaves hospital inpatient or observation care after a stay spanning more than one calendar date. It can include a final examination, discussion of the hospital course with the patient and family, medication reconciliation and prescriptions, instructions for continuing care, coordination with home health, skilled nursing, or follow-up clinicians, and preparation of the discharge summary. Hospitalists, attending internists, family physicians, nurse practitioners, and physician assistants commonly perform this work.
Select 99239 when documented discharge management time on that date exceeds 30 minutes; the work need not be continuous. Record the total minutes and the discharge activities performed. Use 99238 when discharge management takes 30 minutes or less or the time is not documented. The responsible discharging clinician reports the discharge service. A clinician providing a separate, medically necessary hospital visit on the discharge date reports the appropriate hospital E/M code for that encounter, rather than another discharge service.
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.
Where 99239 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $114.12 |
| East St. Louis | Unavailable | $109.62 |
| Rest Of Illinois | Unavailable | $107.00 |
| Suburban Chicago | Unavailable | $111.97 |
How the 99239 rate is calculated
Each of 99239’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 · 99239
RVUs × geographic indexes × conversion factor
Work2.15
2.15 RVUs× 1.000 GPCI
Practice expense0.88
0.88 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
3.1900
Conversion factor
$33.4009
Medicare rate
$106.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99239
99239 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 · 99239
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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99239 isn’t priced in this setting.
99239 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 99238Hospital discharge
- Both cover hospital inpatient or observation discharge management. Use 99238 for 30 minutes or less, or when time is not documented; 99239 requires documented time exceeding 30 minutes.
- 99236Hospital care
- 99236 covers an eligible same-date admission and discharge selected by high medical decision making or qualifying time. Use 99239 for discharge management after a stay spanning more than one date.
- 99233Hospital follow-up visit
- 99233 describes a high-level subsequent hospital visit. The clinician responsible for discharge instead reports the discharge management code for that day.
- 99316Discharge management
- 99316 covers discharge management exceeding 30 minutes for a nursing facility patient; 99239 covers hospital inpatient or observation discharge.
99239 billing questions
How is 99239 chosen over 99238?
The choice depends on documented discharge management time on that date. More than 30 minutes supports 99239; 30 minutes or less, or no documented time, supports 99238.
What activities count toward the discharge time?
Work on the discharge date can include the final exam, counseling the patient and family, reconciling medications, writing prescriptions and instructions, arranging post-discharge care, and completing the discharge summary. The minutes need not be continuous.
Can 99239 be billed when the patient is admitted and discharged on the same date?
No. For a same-date admission and discharge lasting at least eight hours, Medicare uses 99234–99236; a shorter stay is reported with an initial hospital inpatient or observation care code.
Can a consultant or second clinician bill a discharge code on the same day?
The clinician responsible for discharge reports 99238 or 99239. Another clinician who performs a separate, medically necessary visit may report the appropriate hospital E/M code for that encounter, subject to same-specialty, same-group billing rules.
Is a separate code needed for discharge from observation status?
No. For observation care spanning more than one calendar date, use 99238 or 99239 for discharge management based on documented time.
What documentation best supports this level?
Document total discharge management time exceeding 30 minutes on the discharge date and describe the work performed, such as counseling, medication reconciliation, and care coordination.
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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