CPT 99315: Nursing Facility Discharge Management, 30 Minutes or Less
Medicare pays $88 and commercial payers pay $94 on average nationally for this procedure.
CPT code 99315 describes nursing facility discharge management provided by a clinician when the discharge visit requires 30 minutes or less of total face-to-face time; the service type is discharge day management and the typical site of service is a nursing facility (skilled nursing facility or long-term care facility).
For related coverage guidance, see recent payer policy updates: Percutaneous Electrical Nerve Field Stimulation for Functional Abdominal Pain Disorders, Esophagogastroduodenoscopy (EGD) Coverage Policy, Radiofrequency Therapy for Fecal Incontinence.
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National Reimbursement Benchmarks
National means place Blue Cross Blue Shield and UnitedHealth Group above Medicare and roughly aligned with BUCA: Blue Cross Blue Shield mean is $93.4 and UnitedHealth Group mean is $110.4 versus BUCA at $94.5 and Medicare at $88.3. That positions Medicare slightly below BUCA’s commercial average while UnitedHealth Group sits highest among the listed mean values.
Dispersion (P75–P25) highlights variation across payers: Blue Cross Blue Shield’s spread is $29.0 ($106.4–$73.4) and UnitedHealth Group’s spread is $61.6 ($139.5–$72.6), making UnitedHealth Group the widest. Cigna’s spread is $66.3 ($136.7–$70.4) and Aetna’s is $20.5 ($76.0–$55.5), with BUCA’s interquartile spread at $14.1 ($111.9–$69.8) and Medicare’s at $6.0 ($90–$84), indicating Medicare and BUCA have the tightest distributions while Cigna and UnitedHealth Group are the most dispersed.