OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Procedures
  3. 99305
  4. Cost Analysis

How Much Does Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes Cost on Medicare?

Cost analysis for CPT 99305 — Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes

Share:

Average Medicare Payment

$99.11

2023 data

Total Payments (2023)

$94.8M

Services (2023)

934.5K

Price Change (2014–2023)

-2.5%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2014$101.63$94.4M920.3K—
2015$99.96$97.2M964.0K-1.6%
2016$98.68$99.2M994.9K-1.3%
2017$98.35$99.7M1.0M-0.3%
2018$98.93$100.8M1.0M+0.6%
2019$100.10$100.2M989.0K+1.2%
2020$100.15$74.0M726.6K+0.0%
2021$99.65$80.4M790.3K-0.5%
2022$96.78$84.3M850.1K-2.9%
2023$99.11$94.8M934.5K+2.4%

🗺️ State-by-State Cost Variation

The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $123.59 vs OK at $91.29.

StateAvg PaymentTotal PaymentsServicesProviders
AK$123.59$30.3K24510
NY$110.14$15.8M143.7K935
DC$108.03$140.2K1.3K19
CA$106.57$9.5M88.7K705
NJ$105.24$8.0M75.9K754
CT$104.99$1.4M13.8K192
MA$103.88$2.4M23.1K235
MD$102.81$3.6M35.1K323
CO$101.73$456.6K4.5K76
MP$101.57$11.3K1111
IL$101.48$6.8M67.3K613
FL$101.28$9.7M96.0K1.0K
RI$101.23$247.2K2.4K37
HI$100.89$125.9K1.2K19
MT$99.39$59.0K59413
VA$98.98$1.9M18.8K206
WA$98.95$910.5K9.2K98
SD$98.64$34.0K34517
MI$98.57$3.1M31.2K332
XX$98.30$14.0K1422
PA$97.96$4.1M41.9K602
ND$97.72$85.3K87318
DE$97.61$526.1K5.4K40
AZ$97.52$705.6K7.2K87
WY$97.41$58.7K60316
ME$97.28$153.2K1.6K25
WI$96.77$497.6K5.1K106
NV$96.37$606.2K6.3K72
TX$96.36$4.2M43.3K606
MN$96.24$508.8K5.3K110
OH$96.15$3.0M31.3K460
NC$96.00$1.9M19.8K244
KY$95.94$1.0M10.9K137
AL$95.73$790.1K8.3K125
SC$95.50$801.7K8.4K118
GA$95.09$1.2M12.2K159
OR$94.84$202.9K2.1K38
TN$94.56$1.5M15.7K195
WV$94.38$448.9K4.8K73
NM$94.31$181.6K1.9K27
LA$93.89$533.4K5.7K96
VT$93.47$83.1K88926
IN$93.40$2.4M25.6K281
UT$93.26$216.5K2.3K38
NE$93.23$128.3K1.4K25
MO$93.10$1.4M14.5K210
KS$92.97$609.4K6.6K86
NH$92.91$307.7K3.3K55
MS$92.41$440.3K4.8K99
ID$92.15$136.8K1.5K32
IA$91.93$511.4K5.6K91

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Harvey PaleyOtolaryngologyCA$1.0M9.2K$110.79
Simon FensterszaubFamily PracticeNY$640.1K5.7K$112.73
Alla ShabtaiPhysician AssistantNY$573.5K6.1K$93.81
Yosef SeewaldPhysician AssistantNY$452.9K4.9K$92.78
Racquel VolkowitzPhysician AssistantNY$407.1K4.3K$94.26
Shane ManalangPhysician AssistantCA$239.9K2.6K$92.78
Igor RomanovNurse PractitionerNY$197.8K1.9K$102.98
Jonah GreenPhysical Medicine and RehabilitationNY$184.4K1.5K$121.14
Muhammad KhanInfectious DiseaseTX$179.9K1.7K$103.54
Levan AtanelovPhysical Medicine and RehabilitationMD$179.4K1.6K$108.94
David DardashtiPodiatryCA$179.0K1.6K$114.80
Andrew WeissmanPhysician AssistantNY$169.5K1.7K$97.84
Ahmed ElgamalPhysical Medicine and RehabilitationIL$155.5K1.4K$111.96
Christopher KaramPain ManagementNJ$154.9K1.4K$110.82
Benson OnghaiPhysical Medicine and RehabilitationNY$152.6K1.3K$121.59
Kristopher MusgravesPhysical Medicine and RehabilitationIL$152.0K1.4K$109.93
John StevensonInternal MedicineMA$150.0K1.4K$107.99
Allison Ann LyavdanskyNurse PractitionerPA$142.6K1.6K$88.49
William MandrickOphthalmologyCA$141.1K1.3K$112.24
Andrew IsopoInternal MedicineNY$140.6K1.2K$117.69

🤔 Is Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes Overpriced?

Based on the data, CPT 99305 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.

Costs have decreased 2.5% since 2014. Medicare's fee schedule attempts to standardize pricing, though some variation is expected due to geographic cost-of-living adjustments and practice expense differences.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.