CPT 99316

Nursing Facility Dschrg Mgmt 30 Min+ Tot Time

CPT 99316 pays $138.28 in a non-facility setting and $117.57 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $128.60 in Arkansas to $180.67 in Alaska, a 40% spread.

National non-facility rate

$138.28

Office and other outpatient settings

Facility rate
$117.57

Hospital and ASC settings

Highest state
$180.67

Alaska

Lowest state
$128.60

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 $138.28
CPT 99316 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $138.28, national facility $117.57.
StateRate compared visuallyNon-facilityFacility
Alaska
$180.67$158.62
District of Columbia
$152.17$127.78
New York
$149.96$126.85
New Jersey
$149.24$125.92
California
$147.67$123.17
Washington
$146.59$122.98
Massachusetts
$145.83$122.57
Connecticut
$144.92$122.62
Florida
$143.82$123.04
Hawaii
$142.62$119.07
Illinois
$142.09$122.08
Maryland
$141.89$120.30
Colorado
$141.18$119.15
Rhode Island
$140.87$119.48
Oregon
$140.00$118.19
New Hampshire
$139.58$118.03
Puerto Rico
$138.73$117.80
Virgin Islands
$138.73$117.80
Pennsylvania
$138.42$118.13
Montana
$138.27$117.56
Michigan
$137.60$118.15
Texas
$137.57$117.19
Delaware
$137.53$117.07
Nevada
$137.38$116.65
Georgia
$137.26$117.51
Wyoming
$136.80$116.09
Arizona
$135.94$115.87
Virginia
$135.78$115.42
Minnesota
$135.71$114.40
New Mexico
$135.35$116.36
Vermont
$134.98$114.48
North Dakota
$134.91$114.20
Utah
$134.75$115.29
South Dakota
$134.51$113.80
West Virginia
$134.29$116.30
Louisiana
$134.27$115.37
Missouri
$134.15$115.14
Ohio
$134.05$115.15
Maine
$133.97$114.19
South Carolina
$133.70$114.56
North Carolina
$132.94$113.62
Kentucky
$132.35$113.94
Wisconsin
$132.29$112.45
Indiana
$131.78$112.58
Oklahoma
$131.76$113.27
Idaho
$131.36$112.31
Tennessee
$131.18$112.36
Nebraska
$130.97$111.85
Kansas
$130.75$112.03
Iowa
$130.68$111.73
Mississippi
$129.97$112.14
Alabama
$129.68$111.56
Arkansas
$128.60$110.81

Billed by 2 specialties

Commercial rates for 99316

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

See negotiated rates