# CPT 99304

> Medicare paid $92.59 for CPT 99304 in the office (non-facility) setting and $92.59 in a facility under the Q2 2017 Physician Fee Schedule, effective April 2017. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2017, when it increased 0.2%.

## What it is

The first visit by a physician or advanced-practice clinician after a patient is admitted to a nursing facility, at the least involved of the three initial levels. The clinician reviews why the patient was admitted, examines them, reconciles the medications carried over from the hospital, and writes the initial orders and plan of care for the facility staff to follow. What places a visit at this level rather than the two higher ones is straightforward medical decision making, or a shorter total time spent on the patient that day.

## Selected release

- Release: Q2 2017 (2017 B)
- Effective: April 1 – June 30, 2017
- Status indicator: A
- Office (non-facility) national allowed amount: $92.59
- Facility national allowed amount: $92.59
- Sequestration: not applied

## RVUs and formula

- Work RVU: 1.64
- Office (non-facility) practice expense RVU: 0.83
- Facility practice expense RVU: 0.83
- Malpractice RVU: 0.11
- Conversion factor: 35.8887
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q2 2017)
- CMS file: https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu17b.zip
- Parsed file: PPRRVU17_V0209.csv, row 16,357
- Canonical page: https://localishealth.com/cpt/99304/2017/A
- Release-specific citation URL: https://localishealth.com/cpt/99304/2017/B
- Last significant update: 2026-08-04T03:07:42+00:00
