These codes are used to report subsequent nursing facility care services. Subsequent nursing facility care services are defined as encounters that take place in a nursing facility after the initial nursing facility care evaluation.
There are four levels of care for these services. There is significant variability in payment, depending upon the code billed, so it is important to select the level of care which matches the clinical circumstances of the patient to optimize reimbursement.
For these encounters, the level of care may be selected based on the MDM required for the visit OR based on time spent.
The rules for performing and documenting subsequent nursing facility care services are covered extensively in the SUBSEQUENT NURSING FACILITY CARE SERVICES course, which includes clinical examples for all levels of care as well as detailed explanations of the MDM and time required for each visit.
The 99307 level of care requires straightforward MDM or a total of ten minutes spent. This code is used for only 8.4% of these encounters among internists. The reimbursement is about $37.
The 99308 level of care requires low complexity MDM or a total of fifteen minutes spent. This code is used for 44.21% of these encounters among internists. The reimbursement is about $68.
The 99309 level of care requires moderate complexity MDM or a total of thirty minutes spent. This code is used for 41.14% of these encounters among internists. The reimbursement is about $99.
The 99310 level of care requires high complexity MDM or a total of forty-five minutes spent. This code is used for 6.24% of these encounters among internists. The reimbursement is about $140.