Cost analysis for CPT 99306 — Initial nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 1.4x more than the cheapest for this procedure. AK averages $162.32 vs AR at $120.22.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $162.32 | $81.8K | 504 | 10 |
| NY | $154.68 | $17.5M | 113.3K | 1.1K |
| PR | $149.92 | $59.5K | 397 | 2 |
| CA | $147.93 | $20.5M | 138.6K | 1.3K |
| NJ | $147.26 | $11.3M | 76.8K | 850 |
| ND | $144.77 | $243.8K | 1.7K | 16 |
| DC | $144.22 | $387.5K | 2.7K | 40 |
| CT | $144.00 | $3.1M | 21.7K | 245 |
| MD | $143.82 | $6.3M | 43.6K | 391 |
| MA | $143.60 | $6.6M | 46.2K | 371 |
| HI | $143.02 | $182.8K | 1.3K | 24 |
| WA | $139.96 | $2.4M | 17.3K | 150 |
| CO | $139.85 | $2.3M | 16.5K | 127 |
| VA | $139.62 | $4.8M | 34.6K | 294 |
| IL | $139.45 | $8.6M | 61.7K | 686 |
| DE | $139.34 | $659.9K | 4.7K | 33 |
| PA | $139.33 | $8.6M | 61.7K | 755 |
| MI | $138.97 | $4.2M | 30.4K | 346 |
| NH | $138.50 | $725.0K | 5.2K | 57 |
| OR | $136.50 | $493.0K | 3.6K | 56 |
| FL | $136.14 | $18.1M | 133.0K | 1.2K |
| RI | $136.03 | $669.0K | 4.9K | 58 |
| SD | $135.21 | $89.8K | 664 | 14 |
| ME | $134.28 | $427.1K | 3.2K | 48 |
| GA | $134.08 | $2.9M | 21.7K | 256 |
| OH | $134.04 | $4.5M | 33.9K | 482 |
| VT | $133.84 | $168.5K | 1.3K | 30 |
| MT | $133.23 | $179.7K | 1.3K | 24 |
| SC | $132.92 | $2.4M | 18.4K | 163 |
| WI | $132.86 | $1.3M | 9.5K | 117 |
| NV | $132.36 | $2.1M | 15.7K | 143 |
| WV | $132.21 | $586.9K | 4.4K | 57 |
| WY | $132.06 | $72.8K | 551 | 11 |
| AZ | $131.99 | $3.8M | 28.9K | 299 |
| MN | $131.93 | $1.5M | 11.3K | 176 |
| LA | $131.93 | $859.1K | 6.5K | 133 |
| NC | $131.87 | $4.9M | 36.8K | 381 |
| TX | $131.75 | $8.3M | 63.2K | 841 |
| MO | $131.69 | $2.4M | 17.9K | 204 |
| NM | $130.92 | $656.3K | 5.0K | 51 |
| ID | $129.95 | $712.4K | 5.5K | 56 |
| KS | $129.88 | $924.1K | 7.1K | 95 |
| KY | $129.32 | $1.4M | 10.9K | 151 |
| TN | $128.80 | $1.9M | 14.7K | 178 |
| UT | $128.22 | $867.3K | 6.8K | 56 |
| AL | $127.03 | $925.5K | 7.3K | 115 |
| OK | $125.54 | $1.6M | 12.6K | 129 |
| NE | $125.10 | $218.7K | 1.7K | 36 |
| IN | $124.28 | $3.7M | 30.0K | 339 |
| MS | $123.59 | $466.4K | 3.8K | 68 |
| IA | $122.92 | $465.9K | 3.8K | 48 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Thurston Mcmillen | Physical Medicine and Rehabilitation | FL | $687.1K | 4.8K | $142.06 |
| Ritu Rastogi | Internal Medicine | DE | $316.9K | 2.3K | $140.80 |
| Mahmood Kazmi | Neurology | NY | $217.1K | 1.3K | $162.62 |
| Brocha Kagan | Physician Assistant | NY | $212.6K | 1.5K | $140.14 |
| Kunwarjit Duggal | Physical Medicine and Rehabilitation | IN | $209.2K | 1.4K | $146.47 |
| Mustafa Rikabi | Internal Medicine | FL | $189.5K | 1.3K | $147.23 |
| Asif Merchant | Internal Medicine | MA | $186.1K | 1.2K | $153.89 |
| Keino Rutherford | Internal Medicine | CA | $176.7K | 1.1K | $155.53 |
| Lal Yilmaz-Gonzalez | General Surgery | CA | $171.7K | 1.1K | $155.81 |
| Neeru Kumar | Nephrology | NY | $169.3K | 1.0K | $163.11 |
| Mikael Langner | General Practice | CA | $161.8K | 1.0K | $161.30 |
| Charles Welly | General Practice | VA | $160.4K | 1.2K | $139.14 |
| Ilze Hicks | General Practice | FL | $155.4K | 1.1K | $137.36 |
| Eric Kim | Physical Medicine and Rehabilitation | SC | $153.9K | 1.1K | $136.44 |
| Grigoriy Krichmar | Internal Medicine | NY | $153.3K | 908 | $168.81 |
| Tamara Chittenden | Internal Medicine | NC | $146.7K | 1.1K | $136.96 |
| Kevin Neese | Internal Medicine | IN | $145.7K | 1.1K | $135.77 |
| Jessica Rondon | Nurse Practitioner | FL | $144.8K | 1.2K | $123.16 |
| Neil Jaglall | Internal Medicine | NY | $137.5K | 834 | $164.90 |
| Edward Burnetta | Physical Medicine and Rehabilitation | PA | $133.9K | 902 | $148.49 |
Based on the data, CPT 99306 shows a 1.4x variation in pricing across states — relatively consistent by Medicare standards.
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.