No office rate
Both cover same-date hospital admission and discharge; 99235 represents moderate rather than high medical decision making, or its corresponding time-based level.
On this page
CMS RVU26D · Effective 2026-10-01
99236 Hospital care Medicare reimbursement rates in Nebraska
Report this service for high-complexity hospital inpatient or observation care when the patient is admitted and discharged on the same date. Compare 99236 office and facility rates across CMS payment localities in Nebraska.
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 99236 in Nebraska?
Nebraska 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
No supported rate
Facility setting
$179.61
1 of 1 localities have a supported rate.
Payment area: Nebraska
One mapped payment locality.
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.
Hospital E/M
About 99236: Same-day hospital admission and discharge care
Report this service for high-complexity hospital inpatient or observation care when the patient is admitted and discharged on the same date.
This service covers a high-complexity evaluation and management encounter in which a physician or other qualified health care professional admits a patient to inpatient or observation care and discharges the patient on that same calendar date. It may be used in a hospital setting when the patient’s condition and care needs warrant a high level of decision making, such as a serious acute presentation requiring substantial evaluation and management before safe discharge.
Choose this level when medical decision making is high or, when selecting by time, the reporting professional’s total time on the date meets or exceeds 85 minutes. The record should establish the admission and discharge dates and support the selected level through the medical decision-making elements or a time statement. Report one combined same-date service rather than separate admission and discharge E/M services. Medicare values the service through the physician fee schedule; the CMS facts supplied for this code list no additional payment rules.
Where the value comes from
- Work RVU4.30 · 76%
- Practice expense (office) RVU1.02 · 18%
- Malpractice RVU0.36 · 6%
84.1K
Medicare services in 2024 · #613 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.
99236 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
Use 99223 for initial hospital care when the patient is not admitted and discharged on the same date; 99236 combines those same-date services.
No office rate
99238 is discharge management for a discharge on a later date, rather than a same-date admission-and-discharge encounter.
Compare 99236 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$179.61
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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 99236 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
13,026
- Code
- 99236
- Physician work
- 4.30
- Practice expense
- 1.02
- Malpractice
- 0.36
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.30 | × 1.000 | 4.3000 |
| Practice expense | 1.02 | × 0.923 | 0.9415 |
| Malpractice | 0.36 | × 0.378 | 0.1361 |
| Total RVUs | 5.3775 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$179.61
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.3 | 1 |
| Practice expense | 1.02 | 0.923 |
| Malpractice | 0.36 | 0.378 |
(4.3 × 1 + 1.02 × 0.923 + 0.36 × 0.378) × $33.4009 = $179.61
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.
99236 billing questions
When should 99236 be selected instead of 99235?
Use 99236 for same-date admission and discharge when medical decision making is high or total time meets or exceeds 85 minutes. Use 99235 when the supported level is moderate or time meets its applicable threshold.
Can admission and discharge be billed as separate E/M services on the same date?
No. This code represents the combined hospital inpatient or observation admission and discharge service when both occur on the same date.
Can time determine the level?
Yes. The physician’s or qualified health care professional’s total time on the date must meet or exceed 85 minutes. Document the time used to select the service.
What documentation supports 99236?
Document the same-date admission and discharge, the medically appropriate evaluation, and either high-level medical decision making or total time meeting the threshold.
Should 99236 be reported when the patient remains hospitalized after the admission date?
No. For an admission without discharge on that date, select the applicable initial hospital care service; subsequent hospital care applies on later dates.
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.
13,02399233,,Sbsq hosp ip/obs high 50,A,,2.40,0.62,NA,0.62,,0.18,3.20,3.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02499234,,Hosp ip/obs sm dt sf/low 45,A,,2.00,0.46,NA,0.46,,0.18,2.64,2.64,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02599235,,Hosp ip/obs same date mod 70,A,,3.24,0.79,NA,0.79,,0.25,4.28,4.28,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02699236,,Hosp ip/obs same date hi 85,A,,4.30,1.02,NA,1.02,,0.36,5.68,5.68,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02799238,,Hosp ip/obs dschrg mgmt 30/<,A,,1.50,0.62,NA,0.62,,0.12,2.24,2.24,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02899239,,Hosp ip/obs dschrg mgmt >30,A,,2.15,0.88,NA,0.88,,0.16,3.19,3.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,02999242,,Off/op consltj new/est sf 20,I,+,1.08,1.10,,0.51,,0.07,2.25,1.66,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068