{
    "code": "99304",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99304/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/99304/2019/B",
    "description": "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.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99304 in Q2 2019?",
        "text": "Medicare paid $91.54 for CPT 99304 in the office (non-facility) setting and $91.54 in a facility under the Q2 2019 Physician Fee Schedule, effective April 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2019, when it decreased 1.4%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "B",
        "label": "Q2 2019",
        "effective": "April 1 – June 30, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 91.54,
        "facility": 91.54,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 1.64,
        "practice_expense_non_facility": 0.78,
        "practice_expense_facility": 0.78,
        "malpractice": 0.12
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q2 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19b.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/B",
        "file": "PPRRVU19_APR.csv",
        "row": 16841,
        "sha256": "b427bbfdcb61b355ba034840681873d1bd6cdcf51752bdae1bab7c5449efc971"
    },
    "modified_at": "2026-08-04T03:08:53+00:00"
}