CPT 99305

Initial Nursing Facility Care Mod Mdm 35 Minutes

CPT 99305 pays $140.95 in a non-facility setting and $119.91 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $130.78 in Arkansas to $183.35 in Alaska, a 40% spread.

National non-facility rate

$140.95

Office and other outpatient settings

Facility rate
$119.91

Hospital and ASC settings

Highest state
$183.35

Alaska

Lowest state
$130.78

Arkansas · 40% 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 $140.95
CPT 99305 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $140.95, national facility $119.91.
StateRate compared visuallyNon-facilityFacility
Alaska
$183.35$160.94
District of Columbia
$155.30$130.51
New York
$153.02$129.54
New Jersey
$152.23$128.54
California
$150.62$125.72
Washington
$149.51$125.53
Massachusetts
$148.74$125.10
Connecticut
$147.85$125.18
Florida
$146.81$125.70
Hawaii
$145.47$121.54
Illinois
$144.99$124.65
Maryland
$144.69$122.75
Colorado
$143.93$121.54
Rhode Island
$143.59$121.85
Oregon
$142.71$120.54
New Hampshire
$142.31$120.40
Puerto Rico
$141.43$120.15
Virgin Islands
$141.43$120.15
Pennsylvania
$141.06$120.45
Montana
$140.94$119.90
Michigan
$140.26$120.51
Texas
$140.19$119.47
Delaware
$140.14$119.35
Nevada
$140.00$118.94
Georgia
$139.89$119.82
Wyoming
$139.39$118.35
Arizona
$138.49$118.10
Virginia
$138.31$117.62
Minnesota
$138.21$116.56
New Mexico
$137.89$118.59
Vermont
$137.47$116.64
North Dakota
$137.38$116.34
Utah
$137.25$117.47
South Dakota
$136.96$115.92
West Virginia
$136.80$118.52
Louisiana
$136.76$117.55
Missouri
$136.62$117.31
Ohio
$136.52$117.31
Maine
$136.42$116.31
South Carolina
$136.14$116.70
North Carolina
$135.34$115.70
Kentucky
$134.73$116.02
Wisconsin
$134.63$114.47
Indiana
$134.11$114.60
Oklahoma
$134.11$115.32
Idaho
$133.67$114.31
Tennessee
$133.49$114.36
Nebraska
$133.25$113.83
Kansas
$133.03$114.01
Iowa
$132.95$113.70
Mississippi
$132.23$114.12
Alabama
$131.91$113.50
Arkansas
$130.78$112.71

Billed by 2 specialties

Commercial rates for 99305

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

See negotiated rates