CPT code 99310: Nursing facility visit2026 Medicare rate & RVUs in Nevada
Follow-up nursing facility or skilled nursing facility visit for a resident whose care requires high-complexity medical decision making or at least 45 minutes of practitioner time.
Medicare pays $162.22 for 99310 in the office in Nevada (Nevada**). Which amount applies depends on the service address.
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 99310 covers
This is the highest level in the subsequent nursing facility E/M series. It covers a follow-up visit to a skilled nursing facility or long-term nursing facility resident after the initial evaluation. A practitioner might assess suspected sepsis, new respiratory failure, or a severe heart failure or COPD exacerbation and decide whether hospital transfer or a major change in treatment is needed. Attending physicians, geriatricians, nurse practitioners, and physician assistants commonly provide these visits during facility rounds.
Select 99310 when medical decision making is high or the reporting practitioner's qualifying time on the date of service reaches 45 minutes. High MDM requires two of three elements—problems, data, and management risk—at the high level; a hospitalization decision alone does not establish the overall level. Time may include examining the resident, reviewing records, coordinating with facility staff, and documenting, but excludes staff time and work counted toward another reported service. Document the supporting MDM elements or total qualifying time. If the visit is selected by time and Medicare's prolonged-service threshold is met, G0317 may be reported for eligible additional time.
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.
99310 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | $162.22 | $139.15 |
How the 99310 rate is calculated
Each of 99310’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 · 99310
RVUs × geographic indexes × conversion factor
Work2.80
2.80 RVUs× 1.000 GPCI
Practice expense1.88
1.88 RVUs× 1.000 GPCI
Malpractice0.21
0.21 RVUs× 1.000 GPCI
Adjusted RVUs
4.8900
Conversion factor
$33.4009
Medicare rate
$163.33
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99310
99310 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 · 99310
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$163.33
- Non-facility (office)
- $163.33
- Facility
- $140.28
Higher because the practice carries its own overhead.
99310 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 99309Nursing facility visit
- 99309 describes moderate MDM or at least 30 minutes when the higher level is not met; 99310 requires high MDM or at least 45 minutes of qualifying time.
- 99306Nursing facility visit
- 99306 describes an initial nursing facility evaluation at high MDM; 99310 describes a subsequent nursing facility visit.
- 99350Home visit
- 99350 applies to established patients seen at home or in assisted living and similar residences; 99310 applies to residents in a skilled nursing facility or nursing facility.
- 99315Discharge management
- 99315 covers nursing facility discharge management of 30 minutes or less. Choose it instead of 99310 when the service furnished is discharge management.
99310 billing questions
How do I decide between 99309 and 99310?
Use 99310 for high MDM or at least 45 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes when 99310's criteria are not met; a hospitalization decision can support high management risk but does not, by itself, establish high MDM.
Can 99310 be reported for a resident's first visit by our group?
Choose the code based on the service performed, not simply whether the resident is new to the group. Initial nursing facility codes 99304-99306 describe an initial evaluation; 99310 describes subsequent care.
What counts toward the 45 minutes?
Count the reporting practitioner's qualifying work on the date of service, such as examining the resident, reviewing records, coordinating care, ordering, and documenting. Exclude facility staff time and time spent on separately reported services.
How is prolonged time billed for Medicare with 99310?
When 99310 is selected by time and Medicare's threshold for prolonged nursing facility care is met, report G0317 for eligible additional 15-minute increments rather than CPT 99418. Document the total qualifying time.
Which place of service is used?
Use POS 31 for a skilled nursing facility stay and POS 32 for a nursing facility. Visits to assisted living residents fall under home or residence visit codes instead.
Can I bill 99310 and a discharge code for the same service?
No. When the service is nursing facility discharge management, report 99315 or 99316 according to the time spent on that service instead of 99310.
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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