$197.00–$210.29
99306 reports the initial nursing facility E/M service itself. G0317 is added only when qualifying time extends beyond that primary service’s time.
On this page
CMS RVU26D · Effective 2026-10-01
G0317 Prolonged E/M Medicare reimbursement rates in Massachusetts
Reports qualifying additional time spent on a nursing facility evaluation and management service when a high-level visit requires prolonged clinician work. Compare G0317 office and facility rates across CMS payment localities in Massachusetts.
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 G0317 in Massachusetts?
Massachusetts 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
$34.43–$36.76
2 of 2 localities have a supported rate.
Facility setting
$27.39–$28.78
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 G0317: Prolonged nursing facility E/M service
Reports qualifying additional time spent on a nursing facility evaluation and management service when a high-level visit requires prolonged clinician work.
G0317 represents additional time spent by a physician or qualified health care professional on a nursing facility evaluation and management service. It may be relevant when an initial nursing facility assessment or a subsequent visit requires unusually extensive work, such as reviewing a complex medical record, evaluating the resident, discussing the plan with family or facility staff, and coordinating care. The additional time must be attributable to the nursing facility E/M service, not simply the time the clinician is present in the facility.
Report G0317 only with the qualifying primary nursing facility E/M service, 99306 or 99310, when documented total time exceeds the time represented by that primary service. Record the clinician’s qualifying work and total time for the date, separating time already counted toward the base visit from additional time. Each unit represents an additional 15 minutes, subject to the applicable time threshold. CMS classifies G0317 as an add-on code; payment is made with the primary procedure and within that procedure’s global period.
CMS billing rules for G0317
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.61 · 60%
- Practice expense (office) RVU0.36 · 36%
- Malpractice RVU0.04 · 4%
126.9K
Medicare services in 2024 · #496 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.
G0317 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$166.73–$178.58
99310 reports a subsequent nursing facility E/M service. G0317 may be added for qualifying time beyond the primary service’s time.
$35.40–$37.85
G0316 is the prolonged-service add-on for qualifying inpatient or observation E/M services; G0317 is for nursing facility E/M services.
$34.69–$37.05
G0318 applies to qualifying prolonged home or residence E/M services. G0317 applies to qualifying nursing facility E/M services.
Compare G0317 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
Metropolitan Boston →
Office / nonfacility
$36.76
Facility
$28.78
Rest Of Massachusetts →
Office / nonfacility
$34.43
Facility
$27.39
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G0317 billing questions
Which nursing facility visit codes can be paired with G0317?
G0317 is paired with 99306 for qualifying initial nursing facility care or 99310 for qualifying subsequent care. It is not a stand-alone visit code.
When is G0317 appropriate instead of reporting a higher-level visit?
Use the applicable primary visit code based on the service and its selection criteria, then report G0317 only for qualifying additional time beyond the primary service’s time.
What time should the record support?
Document the clinician’s total qualifying time on the date of service and identify the work attributable to the additional time. Do not count time already used to select or support the primary visit.
Can G0317 be billed by itself?
No. It is an add-on code and must be billed with a qualifying primary nursing facility E/M service.
Does G0317 describe a separate procedure or facility service?
No. It reports additional clinician time for the nursing facility E/M service; it does not represent a separate procedure performed by facility staff.
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.
15,191G0314,,Counsel immune <21 16-30 m,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,192G0315,,Counsel immune <21 5-15 m,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,193G0316,,Prolong inpt eval add15 m,A,,0.61,0.38,,0.17,,0.05,1.04,0.83,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,194G0317,,Prolong nursin fac eval 15m,A,,0.61,0.36,,0.16,,0.04,1.01,0.81,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,195G0318,,Prolong home eval add 15m,A,,0.61,0.36,,0.16,,0.05,1.02,0.82,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
15,196G0320,,Two-way audio and video hhs,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
15,197G0321,,Audio-only hhs,X,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00