Nursing facility & home visits

99304 - RVUs & Medicare payment (2026)

Initial nursing facility visit, level 1.

Component	Non-facility	Facility
Work RVU	1.50	1.50
Practice expense RVU	0.84	0.54
Malpractice RVU	0.09	0.09
Total RVUs	2.43	2.13
National payment (CF $33.4009)	$81.16	$71.14
Qualifying APM payment (CF $33.5675)	$81.57	$71.50

How 99304 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 99304 ranges from $75.75 in Arkansas (AR) to $106.69 in Alaska (AK); calculate 99304 for your locality.

Alaska (AK) $106.69 San Jose-Sunnyvale-Santa Clara (CA) $97.68 San Jose-Sunnyvale-Santa Clara (CA) $97.26 San Francisco-Oakland-Berkeley (CA) $95.80 San Francisco-Oakland-Berkeley (CA) $95.70 NYC Suburbs/Long Island (NY) $92.25 Napa (CA) $91.76 Vallejo (CA) $91.62 National average $81.16 … 97 more localities between … Iowa (IA) $76.97 Mississippi (MS) $76.48 Alabama (AL) $76.35 Arkansas (AR) $75.75

Non-facility payment for 99304 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: XXX

No global period: the global surgery concept does not apply to this code.

Related codes - nursing facility & home visits

99305 · initial nursing facility visit, level 2
99306 · initial nursing facility visit, level 3
99307 · subsequent nursing facility visit, level 1
99308 · subsequent nursing facility visit, level 2
99309 · subsequent nursing facility visit, level 3
99310 · subsequent nursing facility visit, level 4
99315 · nursing facility discharge management, 30 minutes or less
99316 · nursing facility discharge management, more than 30 minutes
99341 · home or residence visit, new patient, level 1
99342 · home or residence visit, new patient, level 2
99344 · home or residence visit, new patient, level 4
99345 · home or residence visit, new patient, level 5
99347 · home or residence visit, established patient, level 1
99348 · home or residence visit, established patient, level 2
99349 · home or residence visit, established patient, level 3
99350 · home or residence visit, established patient, level 4

Frequently asked questions

How much does Medicare pay for 99304 in 2026?

The national non-facility payment is $81.16 and the facility payment is $71.14, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 99304?

The 2026 work RVU for 99304 is 1.50. Total RVUs are 2.43 in the non-facility setting and 2.13 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.