Nursing facility & home visits

99305 - RVUs & Medicare payment (2026)

Initial nursing facility visit, level 2.

Component	Non-facility	Facility
Work RVU	2.50	2.50
Practice expense RVU	1.54	0.91
Malpractice RVU	0.18	0.18
Total RVUs	4.22	3.59
National payment (CF $33.4009)	$140.95	$119.91
Qualifying APM payment (CF $33.5675)	$141.65	$120.51

How 99305 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 99305 ranges from $130.78 in Arkansas (AR) to $183.35 in Alaska (AK); calculate 99305 for your locality.

Alaska (AK) $183.35 San Jose-Sunnyvale-Santa Clara (CA) $170.08 San Jose-Sunnyvale-Santa Clara (CA) $169.25 San Francisco-Oakland-Berkeley (CA) $166.72 San Francisco-Oakland-Berkeley (CA) $166.52 NYC Suburbs/Long Island (NY) $161.17 Napa (CA) $159.61 Vallejo (CA) $159.32 National average $140.95 … 97 more localities between … Iowa (IA) $132.95 Mississippi (MS) $132.23 Alabama (AL) $131.91 Arkansas (AR) $130.78

Non-facility payment for 99305 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

99304 · initial nursing facility visit, level 1
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 99305 in 2026?

The national non-facility payment is $140.95 and the facility payment is $119.91, 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 99305?

The 2026 work RVU for 99305 is 2.50. Total RVUs are 4.22 in the non-facility setting and 3.59 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.