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CMS RVU26D · Effective 2026-10-01

99307 Nursing facility visit Medicare reimbursement rates in New Jersey

Report this subsequent nursing facility visit for an encounter supported by straightforward medical decision making or at least 10 minutes of practitioner time. Compare 99307 office and facility rates across CMS payment localities in New Jersey.

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 99307 in New Jersey?

New Jersey 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

$44.75–$46.40

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $1.65 per service.

Facility setting

$39.28–$40.59

2 of 2 localities have a supported rate.

Lowest: Rest Of New Jersey

Highest: Northern Nj

A spread of $1.31 per service.

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.

Find 99307 in your payment locality →

Evaluation and management

About 99307: Subsequent nursing facility visit, straightforward decision making

Report this subsequent nursing facility visit for an encounter supported by straightforward medical decision making or at least 10 minutes of practitioner time.

This is a subsequent evaluation and management visit for a patient in a skilled nursing facility or nursing facility. It may involve assessing a minor, self-limited symptom, reviewing the patient's condition with facility staff, and deciding whether any change in care is needed. Physicians, geriatricians, nurse practitioners, and physician assistants commonly perform these visits during facility rounds. The level depends on the work performed, not simply on whether the visit was scheduled or brief.

Select 99307 using straightforward medical decision making or at least 10 minutes of the billing practitioner's total time on the encounter date. Count qualifying chart review, discussion with facility staff, evaluation, and documentation performed by that practitioner. For decision-making selection, document the problem addressed and the data and management risk considered; a specific amount of data review is not required. Under Medicare, the principal physician of record reports initial nursing facility care, while another practitioner's first visit during the admission may be subsequent care. Use the place of service that reflects the setting: POS 31 for a skilled nursing facility or POS 32 for a nursing facility. Medicare uses facility practice expense for POS 31 and non-facility practice expense for POS 32.

Where the value comes from

  • Work RVU0.70 · 56%
  • Practice expense (office) RVU0.51 · 40%
  • Malpractice RVU0.05 · 4%

1.6M

Medicare services in 2024 · #100 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.

99307 compared with similar codes

Office rates for New Jersey, from the same CMS release.

99308

Nursing facility visit

Subsequent visit, low MDM

$83.83–$86.98

99307 is supported by straightforward MDM or at least 10 minutes; 99308 is supported by low MDM or at least 20 minutes. Select the level using the documented MDM or total time.

99304

Nursing facility care

Initial, straightforward or low complexity

$86.04–$89.01

99304 is initial nursing facility care with straightforward or low MDM. Under Medicare, the principal physician of record reports initial care; another practitioner's first visit during the admission may be reported as subsequent care.

99347

Home visit

Established patient, straightforward MDM

$48.78–$50.43

99347 is for an established patient seen at home or in a residence such as assisted living; 99307 is for care in a skilled nursing facility or nursing facility.

99315

Discharge management

30 minutes or less

$91.15–$94.44

99315 is nursing facility discharge management taking 30 minutes or less. Use 99307 for a subsequent evaluation that is not the practitioner's discharge management work.

Compare 99307 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

Office and facility base rates · shared scale starting at $0

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99307 billing questions

When should 99307 be chosen instead of 99308?

Choose 99307 for straightforward MDM or at least 10 minutes when selecting by time. Choose 99308 for low MDM or at least 20 minutes when selecting by time; 20 minutes does not prevent selection of 99307 based on straightforward MDM.

Can 99307 be billed for a practitioner's first visit during the admission?

Yes, when that practitioner is not the principal physician of record. Under Medicare, the principal physician of record reports initial nursing facility care; other practitioners report subsequent care for their visits, including a first visit.

Does 99307 apply in assisted living facilities?

No. An established patient visit in assisted living is reported from the home or residence visit series, such as 99347 when its level criteria are met.

What counts toward the 10-minute threshold?

Count qualifying time personally spent by the billing practitioner on the encounter date, including evaluation, chart review, care-related discussions with staff or family, ordering, and documentation. Do not count time spent solely by facility nursing staff.

Can 99307 be billed for work performed as discharge management?

Report nursing facility discharge management with 99315 or 99316, according to time, rather than counting that work as a routine subsequent visit. The practitioner's discharge management visit may occur the day before the patient's actual discharge.

Which place of service code should accompany 99307?

Use POS 31 for care in a skilled nursing facility and POS 32 for care in a nursing facility. Medicare applies facility practice expense at POS 31 and non-facility practice expense at POS 32.

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.

RVUs for 99307PPRRVU2026_Oct_nonQPP.csv, line 13,048 (RVU26D)