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
Average Medicare Payment
$99.11
2023 data
Total Payments (2023)
$94.8M
Services (2023)
934.5K
Price Change (2014–2023)
-2.5%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $101.63 | $94.4M | 920.3K | — |
| 2015 | $99.96 | $97.2M | 964.0K | -1.6% |
| 2016 | $98.68 | $99.2M | 994.9K | -1.3% |
| 2017 | $98.35 | $99.7M | 1.0M | -0.3% |
| 2018 | $98.93 | $100.8M | 1.0M | +0.6% |
| 2019 | $100.10 | $100.2M | 989.0K | +1.2% |
| 2020 | $100.15 | $74.0M | 726.6K | +0.0% |
| 2021 | $99.65 | $80.4M | 790.3K | -0.5% |
| 2022 | $96.78 | $84.3M | 850.1K | -2.9% |
| 2023 | $99.11 | $94.8M | 934.5K | +2.4% |
The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $123.59 vs OK at $91.29.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $123.59 | $30.3K | 245 | 10 |
| NY | $110.14 | $15.8M | 143.7K | 935 |
| DC | $108.03 | $140.2K | 1.3K | 19 |
| CA | $106.57 | $9.5M | 88.7K | 705 |
| NJ | $105.24 | $8.0M | 75.9K | 754 |
| CT | $104.99 | $1.4M | 13.8K | 192 |
| MA | $103.88 | $2.4M | 23.1K | 235 |
| MD | $102.81 | $3.6M | 35.1K | 323 |
| CO | $101.73 | $456.6K | 4.5K | 76 |
| MP | $101.57 | $11.3K | 111 | 1 |
| IL | $101.48 | $6.8M | 67.3K | 613 |
| FL | $101.28 | $9.7M | 96.0K | 1.0K |
| RI | $101.23 | $247.2K | 2.4K | 37 |
| HI | $100.89 | $125.9K | 1.2K | 19 |
| MT | $99.39 | $59.0K | 594 | 13 |
| VA | $98.98 | $1.9M | 18.8K | 206 |
| WA | $98.95 | $910.5K | 9.2K | 98 |
| SD | $98.64 | $34.0K | 345 | 17 |
| MI | $98.57 | $3.1M | 31.2K | 332 |
| XX | $98.30 | $14.0K | 142 | 2 |
| PA | $97.96 | $4.1M | 41.9K | 602 |
| ND | $97.72 | $85.3K | 873 | 18 |
| DE | $97.61 | $526.1K | 5.4K | 40 |
| AZ | $97.52 | $705.6K | 7.2K | 87 |
| WY | $97.41 | $58.7K | 603 | 16 |
| ME | $97.28 | $153.2K | 1.6K | 25 |
| WI | $96.77 | $497.6K | 5.1K | 106 |
| NV | $96.37 | $606.2K | 6.3K | 72 |
| TX | $96.36 | $4.2M | 43.3K | 606 |
| MN | $96.24 | $508.8K | 5.3K | 110 |
| OH | $96.15 | $3.0M | 31.3K | 460 |
| NC | $96.00 | $1.9M | 19.8K | 244 |
| KY | $95.94 | $1.0M | 10.9K | 137 |
| AL | $95.73 | $790.1K | 8.3K | 125 |
| SC | $95.50 | $801.7K | 8.4K | 118 |
| GA | $95.09 | $1.2M | 12.2K | 159 |
| OR | $94.84 | $202.9K | 2.1K | 38 |
| TN | $94.56 | $1.5M | 15.7K | 195 |
| WV | $94.38 | $448.9K | 4.8K | 73 |
| NM | $94.31 | $181.6K | 1.9K | 27 |
| LA | $93.89 | $533.4K | 5.7K | 96 |
| VT | $93.47 | $83.1K | 889 | 26 |
| IN | $93.40 | $2.4M | 25.6K | 281 |
| UT | $93.26 | $216.5K | 2.3K | 38 |
| NE | $93.23 | $128.3K | 1.4K | 25 |
| MO | $93.10 | $1.4M | 14.5K | 210 |
| KS | $92.97 | $609.4K | 6.6K | 86 |
| NH | $92.91 | $307.7K | 3.3K | 55 |
| MS | $92.41 | $440.3K | 4.8K | 99 |
| ID | $92.15 | $136.8K | 1.5K | 32 |
| IA | $91.93 | $511.4K | 5.6K | 91 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Harvey Paley | Otolaryngology | CA | $1.0M | 9.2K | $110.79 |
| Simon Fensterszaub | Family Practice | NY | $640.1K | 5.7K | $112.73 |
| Alla Shabtai | Physician Assistant | NY | $573.5K | 6.1K | $93.81 |
| Yosef Seewald | Physician Assistant | NY | $452.9K | 4.9K | $92.78 |
| Racquel Volkowitz | Physician Assistant | NY | $407.1K | 4.3K | $94.26 |
| Shane Manalang | Physician Assistant | CA | $239.9K | 2.6K | $92.78 |
| Igor Romanov | Nurse Practitioner | NY | $197.8K | 1.9K | $102.98 |
| Jonah Green | Physical Medicine and Rehabilitation | NY | $184.4K | 1.5K | $121.14 |
| Muhammad Khan | Infectious Disease | TX | $179.9K | 1.7K | $103.54 |
| Levan Atanelov | Physical Medicine and Rehabilitation | MD | $179.4K | 1.6K | $108.94 |
| David Dardashti | Podiatry | CA | $179.0K | 1.6K | $114.80 |
| Andrew Weissman | Physician Assistant | NY | $169.5K | 1.7K | $97.84 |
| Ahmed Elgamal | Physical Medicine and Rehabilitation | IL | $155.5K | 1.4K | $111.96 |
| Christopher Karam | Pain Management | NJ | $154.9K | 1.4K | $110.82 |
| Benson Onghai | Physical Medicine and Rehabilitation | NY | $152.6K | 1.3K | $121.59 |
| Kristopher Musgraves | Physical Medicine and Rehabilitation | IL | $152.0K | 1.4K | $109.93 |
| John Stevenson | Internal Medicine | MA | $150.0K | 1.4K | $107.99 |
| Allison Ann Lyavdansky | Nurse Practitioner | PA | $142.6K | 1.6K | $88.49 |
| William Mandrick | Ophthalmology | CA | $141.1K | 1.3K | $112.24 |
| Andrew Isopo | Internal Medicine | NY | $140.6K | 1.2K | $117.69 |
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.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.