RxDoctor Payments Data

CPT 99308

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more

$68.91Medicare-allowed amount per service, averaged across 11,622,162 services
Providers submitted
$154.10

Asking price, not received

Medicare allowed
$68.91

The fee schedule figure

Medicare paid
$53.19

Balance is patient coinsurance

Providers submitted an average of $154.10 for this code and Medicare allowed $68.912.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $53.19 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility
$67.97
Hospital / facility
$69.41

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 4,040,593 services were billed in an office setting and 7,581,569 in a facility.

Services
11,622,162

Medicare Part B, 2024

Beneficiaries
2,918,307
Providers billing it
26,213
Total allowed
$800,883,183

Services × allowed amount

What Medicare pays for CPT 99308

Across 11,622,162 services billed by 26,213 providers to 2,918,307 beneficiaries, Medicare allowed an average of $68.91 per service. That is 4.0 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 99308

SpecialtyServicesBeneficiariesAvg allowedProviders
Nurse Practitioner5,277,6631,364,592$62.7712,601
Internal Medicine2,292,962455,920$76.554,291
Family Practice1,022,582262,770$73.242,921
Physician Assistant895,871217,440$64.121,754
Physical Medicine and Rehabilitation668,072137,933$76.41729
Podiatry282,026153,018$75.191,094
General Surgery162,29543,286$76.71220
Psychiatry150,09155,052$74.85387
General Practice115,99828,787$75.41233
Hospitalist103,32326,293$75.48319
Geriatric Medicine98,70828,477$74.25339
Pulmonary Disease92,84013,737$76.37188
Cardiology54,0879,509$78.4390
Infectious Disease47,86111,874$74.04111
Emergency Medicine44,74015,247$73.82143

99308 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

StateServicesAllowedStandardized pmtProviders
New York1,919,577$76.04$53.202,375
Florida1,366,391$68.16$51.832,355
California1,178,025$73.26$53.081,725
New Jersey780,974$73.77$53.031,429
Texas769,024$64.78$50.871,614
Illinois693,840$67.75$51.211,330
Maryland416,168$70.22$51.26711
Pennsylvania415,378$67.89$51.851,425
Ohio377,730$65.09$50.731,268
Massachusetts307,895$67.94$49.83779
Michigan281,320$65.62$50.09838
Indiana256,431$61.50$49.22695
Virginia237,247$65.51$49.71709
North Carolina212,458$62.87$49.61762
Georgia201,649$64.07$50.01527
Tennessee198,092$60.95$49.43601
Missouri193,500$63.56$49.56496
Connecticut179,801$69.51$50.03534
Nevada167,459$64.74$51.54220
Louisiana144,993$62.96$50.08387
Oklahoma144,428$63.44$51.47255
Kentucky130,390$62.36$50.07421
Alabama119,132$61.89$50.06374
Arizona110,618$65.02$52.13311
South Carolina100,676$64.37$50.93378
Mississippi80,172$61.09$50.14257
Kansas63,091$62.36$49.58268
Arkansas56,045$64.37$51.85208
Wisconsin55,673$62.85$50.22297
Washington48,880$67.43$50.03274
Colorado41,834$67.61$50.45257
Iowa37,742$64.64$48.41291
New Hampshire35,153$65.47$48.22144
West Virginia31,967$64.26$49.99161
Minnesota31,134$65.37$49.37294
Delaware29,234$65.83$50.4683
Utah24,826$63.13$50.02112
Nebraska24,504$69.21$51.36119
Rhode Island20,376$67.09$50.24117
District of Columbia18,619$74.16$52.0455
New Mexico16,969$62.83$49.0391
North Dakota15,046$70.21$50.1076
Maine14,111$62.49$47.51100
Hawaii13,457$74.43$53.1958
South Dakota11,985$64.50$47.5290
Oregon11,701$64.90$49.0798
Idaho8,753$61.41$49.3473
Wyoming8,494$70.99$51.6345
Montana7,338$73.55$51.6251
Vermont5,077$64.45$49.2941
XX1,973$64.64$50.182
Alaska1,954$77.97$50.1523
AE1,355$64.81$47.591
Northern Mariana Islands622$70.57$56.251
Puerto Rico444$71.81$57.894
AP282$60.04$46.041

Related codes

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.