CPTCodeCalculator
E/MBase2026 Compliant

CPT 99238

2026 Billing Guide

Hosp Discharge, <31 min

Reimbursement

$57.78

Threshold

30m

2026 Status

Active

What is CPT Code 99238?

CPT 99238 is defined as: Hospital inpatient or observation discharge day management; 30 minutes or less of total time spent by the physician or other qualified health care professional on the date of discharge.

This code is primarily used for E/M services. It falls under the category of Hospital Inpatient/Observation & Emergency Department and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.28

Physician Effort

PE (Non-Fac)

0.35

Practice Expense

Malpractice

0.1

Risk Factor

Total RVU

1.73

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

discharge intensity

Recognizes the administrative and clinical burden of care transitions.

efficiency shield

Exempt from -2.5% efficiency cut.

tcm bridge

Discharge management (99238) is the prerequisite for subsequent TCM (99495-99496) billing.

Administrative Framework

Global Period

000

Place of Service

21 (Inpatient Hospital)22 (On Campus-Outpatient Hospital - Observation)

NCCI Exclusions

Do not bill with:99231-99233 (Mutually exclusive on discharge day)99221-99223 (Exception: if admit/discharge on same day, use 99234-99236, though these are now largely merged with 99221-99223 plus discharge in some systems - check MAC)

Operational Requirements

minimum time

No minimum for 99238; typically up to 30 minutes

staff type

Physician or other Qualified Health Care Professional (QHP)

frequency

Once per hospital stay

add on codes

care plan requirement

Final examination, discussion of hospital stay, instructions for continuing care, and preparation of discharge records/prescriptions.

Compliance Checklist

Final exam of the patient
Discussion of the hospital stay/outcomes
Instructions for home care and follow-up
Coordination of community/home health services if needed
Medication reconciliation and new prescriptions

Audit Defense

No specific audit defense elements defined.

2026 Update

Verify that 'observation discharge' counts toward the hospital stay requirements for TCM if the patient was admitted under observation status.

Common Clinical Scenarios

Preparation of discharge orders and medication list for a stable post-operative patient
Final rounding and discharge education for a patient recovering from pneumonia

CMS Eligibility: Patient ready for discharge to home or community setting. Final day of stay

Target Specialties & Utilization

HospitalistsAny admitting physician

Typical Clinical Indications (ICD-10)

Z53.09 (Discharge summary and follow-up codes)Z71.2 (Person consulting for explanation of medical findings)

Billing Differentiation

VS 99239

99238 is for 30 min or less; 99239 is for MORE than 30 minutes.

VS 99231

99231 is a stay-extension visit; 99238 is the terminal visit of the stay.

Maximize Revenue with AI Confidence

Stop leaving earned revenue on the table. CPT Copilot (Coming Soon) automatically handles the complexity of 2026 CMS policies, identifying every opportunity while ensuring 100% compliance.