Reimbursement
$78.49
Threshold
20m
2026 Status
Active
What is CPT Code 99348?
CPT 99348 is defined as: A home visit for the evaluation and management (E/M) of an established patient, requiring a medically appropriate history and/or examination and a low level of medical decision making (MDM). This service is provided in the patient's residence, which may include a private home, apartment, or a room in an assisted living facility. It is intended for patients whose clinical condition or mobility issues make an office visit difficult or impossible.
This code is primarily used for E/M services. It falls under the category of Evaluation & Management / Home Visit 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
1.2
Physician Effort
PE (Non-Fac)
1.1
Practice Expense
Malpractice
0.05
Risk Factor
Total RVU
2.35
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency shield
Strategically exempt from the -2.5% efficiency adjustment. E/M services are protected to ensure that primary care and home-based management remain financially viable.
g2211 expansion
The 2026 Final Rule allows G2211 to be billed with home visits (99341-99350), providing an additional ~$17.37 boost for complex, longitudinal home-based care.
conversion factor
Utilizes the 2026 Non-QP rate of $33.40.
Administrative Framework
Place of Service
Key Modifiers
Operational Requirements
mdm level
Must meet the criteria for 'Low Complexity' medical decision making, which typically involves two or more stable chronic illnesses or one acute uncomplicated illness.
site verification
The place of service must be the patient's residence. If the service is provided in a clinic or facility that does not meet the definition of a residence, 99211-99215 should be used instead.
longitudinal care
As of 2026, CMS encourages providers to use the G2211 add-on with 99348 when the visit is part of ongoing, comprehensive care for a chronic condition.
travel time exclusion
The time spent traveling to and from the patient's home is NOT included in the Work RVU and cannot be used to determine the level of service.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
G2211 add-on now permitted with this code. Exempt from 2.5% efficiency cuts.
Common Clinical Scenarios
No clinical examples provided.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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