{
    "code": "99305",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/99305/2018/A",
    "release_specific_url": "https://localishealth.com/cpt/99305/2018/A",
    "description": "The first full visit a physician or advanced practice clinician makes to a patient newly admitted to a skilled nursing facility or long-term care unit. It covers a complete history, an examination, and a plan for the stay. This is the middle of the three admission-visit levels: the thinking involved is moderately complex, such as several active problems at once, a new diagnosis that still needs sorting out, or medications that need real adjustment rather than simple continuation. Total time devoted to the patient on that day commonly lands in the mid-thirties of minutes.",
    "answer": {
        "question": "How much did Medicare pay for CPT 99305 in Q1 2018?",
        "text": "Medicare paid $132.84 for CPT 99305 in the office (non-facility) setting and $132.84 in a facility under the Q1 2018 Physician Fee Schedule, effective January 2018. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 0.6% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2018,
        "quarter": "A",
        "label": "Q1 2018",
        "effective": "January 1 – March 31, 2018",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 132.84,
        "facility": 132.84,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 2.35,
        "practice_expense_non_facility": 1.19,
        "practice_expense_facility": 1.19,
        "malpractice": 0.15
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 35.9996,
    "source": {
        "label": "Physician relative value file (Q1 2018)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu18ar1.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2018/A",
        "file": "PPRRVU18_JAN.csv",
        "row": 16515,
        "sha256": "b2c0cf1c065aa6f715438573eb2251381843a90991cf56818aaf33301c43c932"
    },
    "modified_at": "2026-08-04T03:08:09+00:00"
}