$80.44
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.
On this page
CMS RVU26D · Effective 2026-10-01
99307 Nursing facility visit Medicare reimbursement rates in Rhode Island
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 Rhode Island.
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 Rhode Island?
Rhode Island 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
$42.91
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$37.74
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
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 Rhode Island, from the same CMS release.
$82.72
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.
$47.01
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.
$87.55
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.
1 of 1 payment localities
Rhode Island →
Office / nonfacility
$42.91
Facility
$37.74
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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 99307 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
13,048
- Code
- 99307
- Physician work
- 0.70
- Practice expense
- 0.51
- Malpractice
- 0.05
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.70 | × 1.019 | 0.7133 |
| Practice expense | 0.51 | × 1.033 | 0.5268 |
| Malpractice | 0.05 | × 0.892 | 0.0446 |
| Total RVUs | 1.2847 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$42.91
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.7 | 1.019 |
| Practice expense | 0.51 | 1.033 |
| Malpractice | 0.05 | 0.892 |
(0.7 × 1.019 + 0.51 × 1.033 + 0.05 × 0.892) × $33.4009 = $42.91
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.7 | 1.019 |
| Practice expense | 0.36 | 1.033 |
| Malpractice | 0.05 | 0.892 |
(0.7 × 1.019 + 0.36 × 1.033 + 0.05 × 0.892) × $33.4009 = $37.74
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.
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.
13,04599304,,1st nf care sf/low mdm 25,A,,1.50,0.84,,0.54,,0.09,2.43,2.13,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04699305,,1st nf care moderate mdm 35,A,,2.50,1.54,,0.91,,0.18,4.22,3.59,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04799306,,1st nf care high mdm 50,A,,3.50,2.05,,1.16,,0.23,5.78,4.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04899307,,Sbsq nf care sf mdm 10,A,,0.70,0.51,,0.36,,0.05,1.26,1.11,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,04999308,,Sbsq nf care low mdm 20,A,,1.30,0.98,,0.65,,0.08,2.36,2.03,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05099309,,Sbsq nf care moderate mdm 30,A,,1.92,1.37,,0.89,,0.14,3.43,2.95,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05199310,,Sbsq nf care high mdm 45,A,,2.80,1.88,,1.19,,0.21,4.89,4.20,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537