Reimbursement
$58.78
Threshold
20m
2026 Status
Active
What is CPT Code 99341?
CPT 99341 is defined as: Home or residence visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. Typically, the presenting problem(s) are of low severity.
This code is primarily used for E/M services. It falls under the category of Home Evaluation and Management (Home E/M) and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
0.93
Physician Effort
PE (Non-Fac)
0.75
Practice Expense
Malpractice
0.08
Risk Factor
Total RVU
1.76
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
site parity
In 2026, Home E/M codes have been unified with Residence visits, encompassing assisted living settings.
efficiency shield
Exempt from -2.5% efficiency cut.
telehealth transition
Home visits must be performed in-person unless specific telehealth state-of-emergency rules or chronic care waivers apply (verify 2026 rural status).
Administrative Framework
Global Period
000
Place of Service
NCCI Exclusions
Operational Requirements
minimum time
Not time-based (based on MDM)
staff type
Physician or other Qualified Health Care Professional (QHP)
frequency
Once per new patient per specialty
add on codes
care plan requirement
Documentation of home visit necessity and straightforward medical decision making.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Payers are increasing audits on Home E/M to ensure travel time is NOT included in the E/M wRVU calculation.
Common Clinical Scenarios
CMS Eligibility: 1 or more minor acute symptoms or stable chronic issues. Initial engagement
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Billing Differentiation
VS 99342
99342 is for low-to-moderate MDM (higher wRVU).
VS 99347
99347 is for an ESTABLISHED patient.
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