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CMS RVU26D · Effective 2026-10-01

99347 Home visit Medicare reimbursement rates in New Jersey

Established-patient home or residence E/M for a straightforward problem, reported when documented decision-making or at least 20 minutes of clinician time supports this level. Compare 99347 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 99347 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

$48.78–$50.43

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

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.

Find 99347 in your payment locality →

Evaluation and management

About 99347: Established patient home visit, straightforward decision-making

Established-patient home or residence E/M for a straightforward problem, reported when documented decision-making or at least 20 minutes of clinician time supports this level.

99347 is for an E/M encounter with an established patient in a home or residence. A physician or other qualified health care professional assesses the patient’s concern, evaluates relevant history and findings, and develops or updates a straightforward care plan. The setting may be a private home or another residence, such as an assisted living facility or group home. This is not the nursing-facility E/M service family.

Select the level by medical decision-making or, when using time, the clinician’s total time on the date of the encounter. The record should support straightforward MDM, or document at least 20 minutes when time determines the level. Include the patient’s relevant problem, assessment, and plan, and make clear that the service occurred in the home or residence. Report one E/M service for the encounter rather than treating the time threshold as a unit count.

Where the value comes from

  • Work RVU0.90 · 65%
  • Practice expense (office) RVU0.44 · 32%
  • Malpractice RVU0.04 · 3%

509.1K

Medicare services in 2024 · #228 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.

99347 compared with similar codes

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

99348

Home visit

Established patient, low MDM or 30 minutes

$83.48–$86.36

Choose 99347 for straightforward MDM or at least 20 minutes by time. Choose 99348 when low MDM or at least 30 minutes supports the higher level.

99349

Home visit

Established patient, moderate complexity

$140.22–$145.03

99349 requires moderate MDM or at least 40 minutes when selected by time; 99347 is for straightforward MDM or at least 20 minutes.

99341

Home visit

New patient, straightforward MDM

$51.89–$53.59

99341 is the new-patient home or residence E/M level for straightforward MDM. 99347 is for an established patient.

Compare 99347 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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99347 billing questions

How does 99347 differ from 99348?

99347 represents straightforward MDM or at least 20 minutes when selected by time. Use 99348 for low MDM or at least 30 minutes.

Can time determine the code instead of MDM?

Yes. When selecting by time, the clinician must document at least 20 minutes on the date of the encounter; there is no upper time limit for this level.

Can this code be used for an assisted living visit?

Yes, when the encounter is an E/M service in the patient’s residence and the patient is established. A nursing-facility E/M encounter belongs to a different service family.

How is 99347 different from 99341?

Both represent straightforward MDM, but 99347 is for an established patient and 99341 is for a new patient. Their time thresholds also differ.

When might modifier 25 be reported with 99347?

Append modifier 25 when a separately identifiable E/M service is performed on the same date as a procedure and the documentation supports both services.

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 99347PPRRVU2026_Oct_nonQPP.csv, line 13,058 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet