99308

ActiveGlobal n/a

Sbsq nf care low mdm 20

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.

Locality

or ZIP

Show values as

Modifiers

Line	Qty	Non-facility (office)	Facility (hospital/ASC)
99308Sbsq nf care low mdm 20	1	$78.83	$67.80
add-on90833Psytx w pt w e/m 30 min	0	$81.50/ unit	$65.80/ unit
add-on90836Psytx w pt w e/m 45 min	0	$103.21/ unit	$83.17/ unit
add-on90838Psytx w pt w e/m 60 min	0	$136.61/ unit	$110.22/ unit
add-on96160Pt-focused hlth risk assmt	0	$3.01/ unit	$3.01/ unit
add-on96161Caregiver health risk assmt	0	$3.34/ unit	$3.34/ unit
add-onG0506Comp asses care plan ccm svc	0	$66.47/ unit	$38.41/ unit

Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCI_w + PE×GPCI_pe + MP×GPCI_mp) × CF

Row	Work RVU	PE RVU (office)	PE RVU (facility)	MP RVU	Total (office)
99308	1.30	0.98	0.65	0.08	2.36

Payment policy for 99308

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=0

Physician service

Cannot be split into professional/technical components — modifiers 26 and TC don't apply.

Multiple procedures

mult_surg=0

No reduction

No multiple-procedure payment adjustment applies (typical for add-on codes).

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=0

Payable with documentation

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Co-surgeons (modifier 62)

co_surg=0

Not permitted

Co-surgeons (mod 62) may not be paid for this procedure.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.