Top billers · Codes · 99305

Who bills 99305?

99305 is the CPT code for: Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes. In 2024, 10,676 providers billed 99305 1,020,750 times, with an estimated $100.9M paid by Medicare.

$140.95
2026 PFS national rate (office)
10,676
Providers billing it (2024)
1,020,750
Services billed
$100.9M
Est. Medicare paid
The fee

What does Medicare pay for 99305?

Medicare's 2026 Physician Fee Schedule national rate for 99305 is $140.95 in the office setting and $119.91 in a facility. National amounts before geographic adjustment — your locality's rate differs slightly.

Office (non-facility) rate$140.95
Facility rate$119.91
Fee schedule2026 Medicare Physician Fee Schedule

What Medicare actually paid per service in 2024, on average: $98.82 (observed payment across all settings and modifiers — not a fee-schedule rate).

The list

Who bills 99305 the most.

The top 5 billers nationally, ranked by 2024 Medicare service volume.

#ProviderSpecialtyLocationServicesEst. Medicare paid
1Harvey Paley, M.D.OtolaryngologyEncino, CA10,257$1.1M
2Chaim Gitelis, D.O.CardiologyBrooklyn, NY3,784$395K
3Alla Shabtai, RPA-CPhysician AssistantBronx, NY3,196$282K
4Levan Atanelov, M.D.Physical Medicine and RehabilitationOwings Mills, MD2,589$275K
5Shane ManalangPhysician AssistantLynwood, CA2,435$203K

10,671 more providers billed 99305 in 2024. The full ranked list — filtered to your exact territory, with phone numbers and year-over-year history — is one search in Prospect 811.

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The breakdown

Where 99305 gets billed.

Top states by volume

New York139,973 services
Florida123,443 services
California101,745 services
New Jersey79,074 services
Illinois72,790 services
Texas47,942 services
Pennsylvania47,735 services
Maryland41,375 services

About this code

CMS descriptionInitial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes
Code typeCPT (Level I HCPCS)
Providers billing it (2024)10,676
Services billed (2024)1,020,750
Avg. Medicare payment per service (2024)$98.82
Where these numbers come from. Rates are CMS's own public fee-schedule files — the Physician Fee Schedule, Clinical Laboratory Fee Schedule, ASP drug pricing, DMEPOS, and the OPPS/ASC addenda — each labeled with its file year on this page; national amounts are shown before geographic adjustment. Codes with no separate rate render the fee schedule's own status in words, never a fake $0. Utilization comes from CMS's public Medicare Provider Utilization & Payment data for 2024, the most recent year released. It covers traditional Medicare fee-for-service only (no commercial insurance, no Medicare Advantage), and CMS suppresses any provider-and-code line with fewer than 11 beneficiaries before publishing, so low-volume billers don't appear at all. "Est. Medicare paid" is each billing line's average Medicare payment times its service count, summed — actual per-claim payment varies by setting and modifiers. For drug and supply codes, a "service" is a billed unit (a milligram, a milliliter, a square centimeter), not a patient visit. Code descriptions are CMS's own, from the utilization files. Prospect 811 organizes public data; it doesn't add to or alter it. Not affiliated with or endorsed by CMS. Full detail on the data page.

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