99310 Sbsq nf care high mdm 45
Also known as: nursing home complex, SNF high complexity, complex facility visit, nursing facility subsequent level 4
Nursing facility care, subsequent visit for the evaluation and management of a resident, with high medical decision-making complexity.
In Plain Language
Complex nursing home visit; Intensive facility care
Clinical Context
Used for subsequent nursing facility visits with high medical decision-making complexity, such as management of multiple acute conditions or significant clinical deterioration requiring intensive evaluation.
RVU Breakdown
| Work RVU | 2.80 |
| Total RVU | 2.80 |
Est. Medicare Payment
National estimate based on 2026 CMS PFS Conversion Factor ($33.40). Actual payment varies by locality (GPCI adjustment).
Billing & Documentation
E&M codes require documentation of medical decision-making (MDM) complexity or total time spent on the encounter. For 2026, time-based coding includes all physician time on the date of the encounter.
How This Code Compares
With a work RVU of 2.80, this code ranks in the 84th percentile among Evaluation & Management codes — 1.8x the median (1.54). The highest wRVU in this category is 18.46.
Specialties
Frequently Asked Questions
What is CPT code 99310?
CPT 99310 (Sbsq nf care high mdm 45) is a Evaluation & Management code. Nursing facility care, subsequent visit for the evaluation and management of a resident, with high medical decision-making complexity.
Who uses CPT code 99310?
CPT 99310 is used by Family Medicine, Internal Medicine, Geriatrics. Used for subsequent nursing facility visits with high medical decision-making complexity, such as management of multiple acute conditions or significant clinical deterioration requiring intensive evaluation.
When is CPT 99310 used?
Used for subsequent nursing facility visits with high medical decision-making complexity, such as management of multiple acute conditions or significant clinical deterioration requiring intensive evaluation.
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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.