# CPT 99304: Initial nursing facility care, straightforward to low medical decision making

Medicare 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.

Web page: https://www.med-reveal.com/rates/99304-cpt-fee-schedule
Section: Evaluation and Management
Billed by: Evaluation, Internal Medicine

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $81.16 |
| National facility | $71.14 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $106.69 | $96.02 |
| District of Columbia | $89.20 | $77.40 |
| New York | $87.87 | $76.68 |
| New Jersey | $87.53 | $76.25 |
| California | $86.72 | $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 | $83.25 | $72.79 |
| Illinois | $83.13 | $73.45 |
| Colorado | $82.90 | $72.24 |
| Rhode Island | $82.72 | $72.37 |
| Oregon | $82.24 | $71.68 |
| New Hampshire | $81.94 | $71.51 |
| Puerto Rico | $81.43 | $71.30 |
| Virgin Islands | $81.43 | $71.30 |
| Pennsylvania | $81.25 | $71.44 |
| Montana | $81.16 | $71.14 |
| Texas | $80.79 | $70.93 |
| Delaware | $80.77 | $70.87 |
| Nevada | $80.69 | $70.66 |
| Michigan | $80.68 | $71.26 |
| 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 | $78.87 | $69.72 |
| Missouri | $78.80 | $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 |

## Related codes

- 99305: Initial nursing facility care, moderate medical decision making — https://www.med-reveal.com/rates/99305-cpt-fee-schedule
- 99306: Initial nursing facility care, high medical decision making — https://www.med-reveal.com/rates/99306-cpt-fee-schedule
- 99307: Subsequent nursing facility care, straightforward medical decision making — https://www.med-reveal.com/rates/99307-cpt-fee-schedule
- 99308: Subsequent nursing facility care, low medical decision making — https://www.med-reveal.com/rates/99308-cpt-fee-schedule
- 99309: Subsequent nursing facility care, moderate medical decision making — https://www.med-reveal.com/rates/99309-cpt-fee-schedule
- 99310: Subsequent nursing facility care, high medical decision making — https://www.med-reveal.com/rates/99310-cpt-fee-schedule
- 99315: Nursing facility discharge day management, 30 minutes or less — https://www.med-reveal.com/rates/99315-cpt-fee-schedule
- 99316: Nursing facility discharge day management, more than 30 minutes — https://www.med-reveal.com/rates/99316-cpt-fee-schedule

Commercial negotiated rates for 99304 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules