CPT 99304

Initial Nursing Facility Care Sf/Low Mdm 25 Min

CPT 99304 pays $81.16 in a non-facility setting and $71.14 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $75.75 in Arkansas to $106.69 in Alaska, a 41% spread.

National non-facility rate

$81.16

Office and other outpatient settings

Facility rate
$71.14

Hospital and ASC settings

Highest state
$106.69

Alaska

Lowest state
$75.75

Arkansas · 41% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $81.16
CPT 99304 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $81.16, national facility $71.14.
StateRate compared visuallyNon-facilityFacility
Alaska
$106.69$96.02
District of Columbia
$89.20$77.40
New York
$87.86$76.68
New Jersey
$87.53$76.24
California
$86.73$74.87
Washington
$86.04$74.61
Massachusetts
$85.59$74.33
Connecticut
$84.96$74.17
Florida
$84.10$74.05
Hawaii
$83.74$72.35
Maryland
$83.24$72.79
Illinois
$83.13$73.45
Colorado
$82.90$72.24
Rhode Island
$82.72$72.37
Oregon
$82.23$71.68
New Hampshire
$81.94$71.51
Puerto Rico
$81.43$71.30
Virgin Islands
$81.43$71.30
Pennsylvania
$81.25$71.43
Montana
$81.16$71.14
Texas
$80.79$70.93
Delaware
$80.77$70.87
Nevada
$80.69$70.66
Michigan
$80.68$71.27
Georgia
$80.54$70.98
Wyoming
$80.38$70.36
Arizona
$79.86$70.15
Minnesota
$79.86$69.55
Virginia
$79.80$69.95
New Mexico
$79.44$70.25
Vermont
$79.40$69.48
North Dakota
$79.38$69.36
South Dakota
$79.17$69.15
Utah
$79.17$69.76
Louisiana
$78.86$69.72
Missouri
$78.81$69.61
Maine
$78.79$69.22
West Virginia
$78.78$70.08
Ohio
$78.75$69.60
South Carolina
$78.58$69.32
North Carolina
$78.20$68.85
Wisconsin
$77.91$68.31
Kentucky
$77.79$68.89
Indiana
$77.57$68.28
Oklahoma
$77.49$68.54
Idaho
$77.34$68.12
Tennessee
$77.22$68.11
Nebraska
$77.13$67.89
Kansas
$76.98$67.92
Iowa
$76.97$67.80
Mississippi
$76.48$67.85
Alabama
$76.35$67.58
Arkansas
$75.75$67.14

Billed by 2 specialties

Commercial rates for 99304

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates