$87.55
Both codes describe nursing facility discharge-day management. Choose 99316 when total time is more than 30 minutes; choose 99315 for 30 minutes or less.
On this page
CMS RVU26D · Effective 2026-10-01
99316 Discharge management Medicare reimbursement rates in Rhode Island
Report nursing facility discharge management when a physician or qualified health professional provides discharge-day evaluation and coordination requiring more than 30 minutes. Compare 99316 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 99316 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
$140.87
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$119.48
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 99316: Nursing facility discharge management, extended time
Report nursing facility discharge management when a physician or qualified health professional provides discharge-day evaluation and coordination requiring more than 30 minutes.
Code 99316 describes discharge-day management for a patient leaving a nursing facility. A physician or other qualified health professional may perform the service before discharge to home, assisted living, or another care setting. The work can include a final examination, discussion of the discharge plan and instructions with the patient or caregiver, preparation of discharge records and prescriptions, arranging referrals, and communicating with other professionals involved in the transition.
Select this code when the total time spent on discharge management is more than 30 minutes; use 99315 when the service takes 30 minutes or less. Document the discharge date, total time, and the management activities performed. The activities involved in completing the discharge are represented by the discharge-management service rather than itemized as separate discharge-management codes. CMS fee-schedule data assign work, practice-expense, and malpractice relative value units to the service.
Where the value comes from
- Work RVU2.50 · 60%
- Practice expense (office) RVU1.47 · 36%
- Malpractice RVU0.17 · 4%
378K
Medicare services in 2024 · #270 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.
99316 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$116.79
99309 describes subsequent nursing facility care, not discharge management. Use it for a qualifying facility follow-up encounter rather than work preparing the patient to leave.
$80.40
99348 is an established-patient home or residence visit. It may describe a separate post-discharge visit, whereas 99316 covers nursing facility discharge-day work.
Compare 99316 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
$140.87
Facility
$119.48
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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 99316 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
13,053
- Code
- 99316
- Physician work
- 2.50
- Practice expense
- 1.47
- Malpractice
- 0.17
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.50 | × 1.019 | 2.5475 |
| Practice expense | 1.47 | × 1.033 | 1.5185 |
| Malpractice | 0.17 | × 0.892 | 0.1516 |
| Total RVUs | 4.2176 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$140.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.5 | 1.019 |
| Practice expense | 1.47 | 1.033 |
| Malpractice | 0.17 | 0.892 |
(2.5 × 1.019 + 1.47 × 1.033 + 0.17 × 0.892) × $33.4009 = $140.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.5 | 1.019 |
| Practice expense | 0.85 | 1.033 |
| Malpractice | 0.17 | 0.892 |
(2.5 × 1.019 + 0.85 × 1.033 + 0.17 × 0.892) × $33.4009 = $119.48
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.
99316 billing questions
How does 99316 differ from 99315?
The distinction is total discharge-management time: 99316 is for more than 30 minutes, while 99315 is for 30 minutes or less. Document the time supporting the selected code.
What work can count toward the discharge-management service?
The service may include the final examination, discharge-plan discussion and instructions, preparing records or prescriptions, arranging referrals, and communicating with other professionals about the transition.
What time and documentation should the record show?
Record the discharge date, total time spent on discharge management, and the activities performed. The documented total must exceed 30 minutes for 99316.
Is a routine nursing facility follow-up visit the same service?
No. Discharge management addresses the work of preparing a patient to leave the facility; subsequent nursing facility care codes describe follow-up care while the patient remains in the facility.
Can post-discharge home care be reported as 99316?
No. Code 99316 describes nursing facility discharge-day management, not a later home or residence visit. Select a home or residence E/M code when a separate visit occurs after discharge.
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.
13,05099309,,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
13,05299315,,Nf dschrg mgmt 30 min/less,A,,1.50,0.98,,0.60,,0.09,2.57,2.19,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05399316,,Nf dschrg mgmt 30 min+,A,,2.50,1.47,,0.85,,0.17,4.14,3.52,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05499341,,Home/res vst new sf mdm 15,A,,1.00,0.43,,0.43,NA,0.04,1.47,1.47,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05599342,,Home/res vst new low mdm 30,A,,1.65,0.64,,0.64,NA,0.07,2.36,2.36,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
13,05699344,,Home/res vst new mod mdm 60,A,,2.87,1.36,,1.36,NA,0.16,4.39,4.39,0,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