$76.06
Both are new-patient home or residence visits. 99341 is for straightforward MDM or its lower time level; 99342 is for low MDM or its higher time threshold.
On this page
CMS RVU26D · Effective 2026-10-01
99341 Home visit Medicare reimbursement rates in Indiana
Reports a new patient evaluation in a home or residence when the encounter supports straightforward medical decision making or at least 15 minutes of total time. Compare 99341 office and facility rates across CMS payment localities in Indiana.
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 99341 in Indiana?
Indiana 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
$47.36
1 of 1 localities have a supported rate.
Payment area: Indiana
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 99341: New patient home or residence visit
Reports a new patient evaluation in a home or residence when the encounter supports straightforward medical decision making or at least 15 minutes of total time.
A physician or other qualified health professional reports this evaluation and management service for a new patient seen in a private home or another residence, such as an assisted living facility or group home. The encounter addresses the patient's health needs at that location; the service is not an initial nursing facility visit. The clinician performs a medically appropriate history and/or examination as indicated by the problem.
Select this code when medical decision making is straightforward, or when using time for code selection, the clinician documents at least 15 minutes of qualifying total time on the encounter date. The patient must meet the new-patient definition: no professional service in the preceding three years from the clinician or another clinician of the same specialty and subspecialty in the same group. The record should support the residence setting, new-patient status, assessment and plan, and the MDM or time basis for the level.
Where the value comes from
- Work RVU1.00 · 68%
- Practice expense (office) RVU0.43 · 29%
- Malpractice RVU0.04 · 3%
56.1K
Medicare services in 2024 · #743 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.
99341 compared with similar codes
Office rates for Indiana, from the same CMS release.
$44.33
99347 is for an established patient in a home or residence. Use 99341 only when the patient meets the new-patient definition.
$134.11
99305 is initial nursing facility care with moderate MDM, not an evaluation in a patient's home or residence.
Compare 99341 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
Indiana →
Office / nonfacility
$47.36
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 99341 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
13,054
- Code
- 99341
- Physician work
- 1.00
- Practice expense
- 0.43
- Malpractice
- 0.04
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.00 | × 1.000 | 1.0000 |
| Practice expense | 0.43 | × 0.927 | 0.3986 |
| Malpractice | 0.04 | × 0.486 | 0.0194 |
| Total RVUs | 1.4181 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$47.36
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1 | 1 |
| Practice expense | 0.43 | 0.927 |
| Malpractice | 0.04 | 0.486 |
(1 × 1 + 0.43 × 0.927 + 0.04 × 0.486) × $33.4009 = $47.36
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.
99341 billing questions
When should 99341 be chosen instead of 99342?
Use 99341 for straightforward medical decision making or at least 15 minutes when selecting by time. Choose 99342 when the encounter supports low medical decision making or its applicable time threshold.
What makes the patient new for this code?
The patient has not received a professional service in the preceding three years from the reporting clinician or another clinician of the same specialty and subspecialty in the same group.
Can the code be selected by time rather than medical decision making?
Yes. Document at least 15 minutes of qualifying total time on the date of the encounter when using time to select 99341.
Is 99341 used for an initial nursing facility visit?
No. It is for an evaluation in a home or residence. Initial nursing facility care is reported from the nursing facility E/M code family.
What should the note support?
Document the residence setting, the patient's new-patient status, the medically appropriate evaluation, and the straightforward MDM or qualifying total time used to select the code.
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.
13,05199310,,Sbsq nf care high mdm 45,A,,2.80,1.88,,1.19,,0.21,4.89,4.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05299315,,Nf dschrg mgmt 30 min/less,A,,1.50,0.98,,0.60,,0.09,2.57,2.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05399316,,Nf dschrg mgmt 30 min+,A,,2.50,1.47,,0.85,,0.17,4.14,3.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05499341,,Home/res vst new sf mdm 15,A,,1.00,0.43,,0.43,NA,0.04,1.47,1.47,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05599342,,Home/res vst new low mdm 30,A,,1.65,0.64,,0.64,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
13,05699344,,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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915