CPT 99308: Subsequent Nursing Facility Care, Low Complexity
Medicare pays $81 and commercial payers pay $88 on average nationally for this procedure.
CPT code 99308 describes a subsequent nursing facility care visit for evaluation and management where the clinician provides a low level of medical decision making and/or documents at least 20 minutes of total face-to-face time on a single date; service type: evaluation and management (E/M) subsequent nursing facility care; typical site of service: nursing facility (skilled nursing facility or long-term care facility).
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National Reimbursement Benchmarks
Commercial averages cluster above Medicare for CPT 99308: Blue Cross Blue Shield, Aetna, Cigna, UnitedHealth Group and BUCA all show mean rates higher than Medicare’s $81.2 mean. BUCA’s mean of $87.7 sits modestly above Medicare’s $81.2, while Cigna ($103.3), UnitedHealth Group ($93.7), Blue Cross Blue Shield ($86.0) and Aetna ($71.1) span the commercial spectrum with Cigna at the top among provided means.
Dispersion measured by interquartile range (P75–P25) is narrowest for Aetna at $21.8 and tight for UnitedHealth Group at $52.4? — correction: computed ranges are Aetna $21.8, Blue Cross Blue Shield $23.3, BUCA $36.3, UnitedHealth Group $52.4, Cigna $64.7. Cigna exhibits the widest IQR at $64.7, indicating greater mid-distribution variability, while Aetna and Blue Cross Blue Shield are the tightest among the listed payers.