Billing code 99316: Discharge managementMedicare rate & RVUs in Utah
Report nursing facility discharge management when a physician or qualified health professional provides discharge-day evaluation and coordination requiring more than 30 minutes.
Medicare pays $134.75 for 99316 in the office in Utah (Utah). 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 99316 covers
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.
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 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $134.75 | $115.29 |
How the 99316 rate is calculated
Each of 99316’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 · 99316
RVUs × geographic indexes × conversion factor
Work2.50
2.50 RVUs× 1.000 GPCI
Practice expense1.47
1.47 RVUs× 1.000 GPCI
Malpractice0.17
0.17 RVUs× 1.000 GPCI
Adjusted RVUs
4.1400
Conversion factor
$33.4009
Medicare rate
$138.28
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 99316
99316 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 · 99316
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$138.28
- Non-facility (office)
- $138.28
- Facility
- $117.57
Higher because the practice carries its own overhead.
99316 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 99315Discharge management
- 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.
- 99309Nursing facility visit
- 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.
- 99348Home visit
- 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.
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 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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