Cost analysis for CPT 99316 — Nursing facility discharge management, more than 30 minutes
Average Medicare Payment
$92.37
2023 data
Total Payments (2023)
$30.5M
Services (2023)
326.3K
Price Change (2014–2023)
+19.8%
| Year | Avg Payment | Total Payments | Services | YoY Change |
|---|---|---|---|---|
| 2014 | $77.09 | $23.0M | 299.7K | — |
| 2015 | $76.90 | $25.6M | 333.4K | -0.2% |
| 2016 | $76.55 | $27.4M | 358.2K | -0.5% |
| 2017 | $76.31 | $28.4M | 373.3K | -0.3% |
| 2018 | $76.60 | $29.5M | 385.7K | +0.4% |
| 2019 | $76.95 | $30.6M | 398.5K | +0.5% |
| 2020 | $77.28 | $22.8M | 295.2K | +0.4% |
| 2021 | $76.52 | $24.1M | 312.5K | -1.0% |
| 2022 | $73.97 | $23.8M | 319.6K | -3.3% |
| 2023 | $92.37 | $30.5M | 326.3K | +24.9% |
The most expensive state pays 1.6x more than the cheapest for this procedure. AK averages $133.82 vs NE at $81.37.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| AK | $133.82 | $22.9K | 171 | 10 |
| CA | $105.81 | $2.6M | 24.8K | 384 |
| NY | $105.32 | $3.8M | 36.2K | 624 |
| ND | $104.56 | $91.2K | 872 | 14 |
| NJ | $102.51 | $1.6M | 15.3K | 312 |
| DC | $101.57 | $35.8K | 352 | 8 |
| HI | $99.39 | $79.3K | 798 | 25 |
| MD | $95.56 | $1.3M | 13.9K | 227 |
| NV | $94.42 | $467.0K | 4.9K | 71 |
| WV | $94.39 | $146.7K | 1.6K | 31 |
| IL | $94.08 | $1.1M | 11.7K | 248 |
| FL | $93.81 | $2.0M | 21.1K | 370 |
| AZ | $93.69 | $555.6K | 5.9K | 101 |
| MA | $92.99 | $1.6M | 17.0K | 276 |
| PA | $92.05 | $1.4M | 15.6K | 392 |
| TX | $91.90 | $798.8K | 8.7K | 235 |
| VT | $91.13 | $80.6K | 885 | 29 |
| CT | $91.03 | $679.3K | 7.5K | 168 |
| RI | $90.83 | $52.6K | 579 | 16 |
| VA | $90.19 | $1.4M | 15.2K | 272 |
| WA | $90.10 | $625.1K | 6.9K | 129 |
| CO | $89.88 | $414.4K | 4.6K | 96 |
| GA | $89.78 | $442.7K | 4.9K | 122 |
| MO | $89.72 | $284.9K | 3.2K | 77 |
| MT | $89.38 | $92.2K | 1.0K | 29 |
| SD | $89.19 | $35.9K | 403 | 18 |
| MI | $88.95 | $989.8K | 11.1K | 243 |
| ME | $88.65 | $137.5K | 1.6K | 48 |
| DE | $88.53 | $206.3K | 2.3K | 35 |
| NH | $88.27 | $178.4K | 2.0K | 60 |
| OK | $87.75 | $196.2K | 2.2K | 47 |
| OH | $87.69 | $833.4K | 9.5K | 246 |
| UT | $87.44 | $171.9K | 2.0K | 30 |
| NM | $87.43 | $81.4K | 931 | 25 |
| AL | $87.41 | $157.5K | 1.8K | 45 |
| WY | $87.28 | $16.2K | 186 | 5 |
| LA | $87.19 | $182.5K | 2.1K | 68 |
| NC | $87.12 | $1.0M | 12.0K | 266 |
| MN | $85.98 | $586.3K | 6.8K | 170 |
| OR | $85.95 | $213.0K | 2.5K | 57 |
| KY | $85.23 | $292.9K | 3.4K | 90 |
| SC | $85.09 | $605.0K | 7.1K | 155 |
| WI | $84.59 | $457.4K | 5.4K | 141 |
| MS | $84.29 | $187.5K | 2.2K | 57 |
| KS | $84.25 | $347.4K | 4.1K | 84 |
| AR | $84.17 | $52.6K | 625 | 24 |
| ID | $83.88 | $228.9K | 2.7K | 48 |
| IN | $82.81 | $577.5K | 7.0K | 148 |
| IA | $82.35 | $153.4K | 1.9K | 49 |
| TN | $82.25 | $661.9K | 8.0K | 164 |
| NE | $81.37 | $198.5K | 2.4K | 40 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Samy Saker | Internal Medicine | NY | $68.3K | 592 | $115.31 |
| Mark Gobrial | Internal Medicine | CA | $66.2K | 599 | $110.50 |
| Andrew Chi | Internal Medicine | CA | $58.7K | 490 | $119.82 |
| Keino Rutherford | Internal Medicine | CA | $55.9K | 502 | $111.35 |
| Sri Vardhan Reddy Kooturu | Internal Medicine | ND | $54.4K | 468 | $116.18 |
| Neil Jaglall | Internal Medicine | NY | $54.1K | 452 | $119.69 |
| John Hurwitz | Internal Medicine | CA | $46.7K | 435 | $107.40 |
| Neriy Yakubov | Hospitalist | NY | $44.1K | 376 | $117.21 |
| Alireza Shirvani | Internal Medicine | NY | $42.5K | 357 | $118.92 |
| David Julian | Internal Medicine | NV | $39.4K | 383 | $103.00 |
| Dzung Trinh | Internal Medicine | CA | $36.9K | 351 | $105.07 |
| Zev Lati | Internal Medicine | NY | $35.6K | 300 | $118.78 |
| Cynthia Pinson | Family Practice | WV | $35.1K | 368 | $95.43 |
| Ali Tabatabai | Internal Medicine | CA | $34.7K | 314 | $110.36 |
| Mark Pass | Geriatric Medicine | NJ | $34.4K | 316 | $108.85 |
| Jay Stambler | Internal Medicine | NY | $34.3K | 286 | $119.81 |
| Kaushal Nanavati | Internal Medicine | NJ | $34.2K | 304 | $112.56 |
| Katie Kwaschyn | Internal Medicine | NC | $34.1K | 285 | $119.81 |
| Qingzhi Wu | Nurse Practitioner | CA | $34.1K | 337 | $101.13 |
| William Bichai | Nephrology | CA | $33.3K | 320 | $104.10 |
Based on the data, CPT 99316 shows a 1.6x variation in pricing across states — moderate variation by Medicare standards.
Costs have increased 19.8% 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.