$41.09
99307 requires straightforward MDM or at least 10 minutes. Choose 99308 when the overall MDM is low or qualifying time reaches 20 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
99308 Nursing facility visit Medicare reimbursement rates in Vermont
Report a subsequent skilled nursing or nursing facility visit when the practitioner documents low medical decision making or at least 20 minutes of qualifying time. Compare 99308 office and facility rates across CMS payment localities in Vermont.
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 99308 in Vermont?
Vermont 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
$77.18
1 of 1 localities have a supported rate.
Payment area: Vermont
One mapped payment locality.
Facility setting
$66.27
1 of 1 localities have a supported rate.
Payment area: Vermont
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 99308: Subsequent nursing facility visit, low complexity
Report a subsequent skilled nursing or nursing facility visit when the practitioner documents low medical decision making or at least 20 minutes of qualifying time.
Physicians, nurse practitioners, and physician assistants report 99308 for a subsequent evaluation of a resident in a skilled nursing facility or nursing facility. The encounter may address ongoing conditions, a new uncomplicated illness, or a change in care needs. Managing two stable chronic illnesses can support the problem element of low medical decision making (MDM), but the overall MDM level depends on at least two of its three elements. Work may include reviewing nursing observations, examining the resident, discussing care with facility staff, and updating treatment orders.
Select 99308 when the documented MDM is low or the reporting practitioner spends at least 20 minutes on qualifying work on the encounter date. Count the practitioner's face-to-face and non-face-to-face E/M work, including chart review, staff discussions, orders, and documentation; exclude facility staff time and time spent on separately reported services. Document the problems and management decisions supporting MDM or the total time supporting time-based selection. Medicare uses the facility rate for place of service (POS) 31, skilled nursing facility, and the nonfacility rate for POS 32, nursing facility.
Where the value comes from
- Work RVU1.30 · 55%
- Practice expense (office) RVU0.98 · 42%
- Malpractice RVU0.08 · 3%
11.8M
Medicare services in 2024 · #18 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.
99308 compared with similar codes
Office rates for Vermont, from the same CMS release.
$111.80
99309 requires moderate MDM or at least 30 minutes; 99308 requires low MDM or at least 20 minutes. A worsening condition or prescription drug management alone does not determine the overall MDM level.
$79.40
99304 is for an initial nursing facility evaluation with straightforward or low MDM or at least 25 minutes. Use 99308 for a subsequent evaluation meeting its low-MDM or 20-minute threshold.
$77.41
99348 is for an established patient seen in a home or residence setting, including assisted living. Use the nursing facility visit family for skilled nursing or nursing facility residents, selecting 99308 when its level criteria are met.
Compare 99308 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
Vermont →
Office / nonfacility
$77.18
Facility
$66.27
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 99308 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
13,049
- Code
- 99308
- Physician work
- 1.30
- Practice expense
- 0.98
- Malpractice
- 0.08
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.30 | × 1.000 | 1.3000 |
| Practice expense | 0.98 | × 0.990 | 0.9702 |
| Malpractice | 0.08 | × 0.506 | 0.0405 |
| Total RVUs | 2.3107 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$77.18
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.3 | 1 |
| Practice expense | 0.98 | 0.99 |
| Malpractice | 0.08 | 0.506 |
(1.3 × 1 + 0.98 × 0.99 + 0.08 × 0.506) × $33.4009 = $77.18
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.3 | 1 |
| Practice expense | 0.65 | 0.99 |
| Malpractice | 0.08 | 0.506 |
(1.3 × 1 + 0.65 × 0.99 + 0.08 × 0.506) × $33.4009 = $66.27
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.
99308 billing questions
How do I choose between this code and 99309?
Use 99308 for low MDM or at least 20 minutes of qualifying time. Use 99309 for moderate MDM or at least 30 minutes; prescription drug management alone does not establish moderate MDM.
Can a nurse practitioner bill this visit?
Yes. Nurse practitioners and physician assistants may report subsequent nursing facility visits under their own NPI, subject to Medicare and state scope-of-practice requirements.
What time counts toward the 20 minutes?
Count the reporting practitioner's qualifying work on the encounter date, such as reviewing records, examining the resident, speaking with nursing staff or family, entering orders, and documenting. Exclude facility staff time and time spent on separately reported services.
Which place of service do I use?
Use POS 31 for a skilled nursing facility and POS 32 for a nursing facility. Medicare uses the facility rate for POS 31 and the nonfacility rate for POS 32.
Can I bill this on the day the resident is discharged from the facility?
When the practitioner performs discharge-day management, report 99315 or 99316 for that work rather than 99308. Select the discharge code based on the time spent on discharge management.
Can prolonged service time be added to this level?
No. Medicare's prolonged nursing facility E/M service for subsequent care pairs with 99310 when its time requirements are met, rather than with 99308.
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.
13,04699305,,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
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
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817