Welcome to This Month’s Feature Code
Billing for Skilled Nursing Facility (SNF) services comes with its own set of rules, expectations, and payer requirements. If your team is handling initial SNF visit billing, then you already know that accuracy equals reimbursement — and CPT 99306 is a code you can’t afford to misuse.
This month at Reenix Excellence, we’re spotlighting CPT 99306 for SNF visits to help providers and billing teams avoid costly denials, get paid faster, and stay fully compliant.
What is CPT 99306?
CPT 99306 is a Skilled Nursing Facility CPT code used to report an initial, comprehensive evaluation for a patient newly admitted to a SNF.
It applies when a physician or qualified healthcare provider conducts a detailed assessment and assumes responsibility for ongoing care.
This service includes:
- A comprehensive history
- A comprehensive physical exam
- Moderate to high complexity medical decision-making
- ~45 minutes of face-to-face time with the patient
Used once per admission per provider group — not for follow-ups or subsequent visits.
When Should You Use CPT 99306?
Use CPT 99306 for SNF visits when:
- The patient is newly admitted to a SNF or intermediate care facility
- The provider is responsible for developing the initial care plan
- The patient’s condition requires a high-complexity evaluation
Reenix Tip: This is also the initial nursing home evaluation code most appropriate when assuming full care responsibility for a new SNF patient.
Documentation Checklist
To bill CPT 99306 successfully, documentation must reflect all of the following:
| Required Element | Notes |
| Chief complaint & HPI | Specific to current condition and reason for SNF admission |
| Review of Systems (ROS) | Thorough and covers multiple systems |
| Past, Family, Social History (PFSH) | Fully documented |
| Comprehensive Physical Exam | Multi-system assessment |
| Moderate to High Complexity MDM | Supported by multiple diagnoses, risk levels, and decision points |
| Face-to-face time (≈ 45 minutes) | Must be stated clearly in the note |
Reenix coders validate every claim against these requirements to support accurate Medicare billing for nursing home visits.
Reimbursement Expectations
The average reimbursement for CPT 99306 ranges from $135 to $165, depending on your location and payer. But getting paid depends on clean claims supported by accurate documentation.
Common denial reasons:
- Missing or vague documentation
- Incorrect time statement
- Wrong POS (Place of Service) code
- Multiple providers billing for the same E/M code
Reenix Excellence proactively addresses these issues before submission, helping you improve first-pass resolution rates and accelerate payments.
CPT 99306 vs. Other Initial SNF Visit Codes
Understanding when to use this E/M code for SNF admission is essential to avoid both underbilling and compliance risk.
| Code | Medical Decision-Making | Time (Approx.) |
| 99304 | Straightforward/Low | ~25 minutes |
| 99305 | Moderate | ~35 minutes |
| 99306 | Moderate–High | ~45 minutes |
Choosing the right level starts with documentation. Reenix’s certified coders help your practice code confidently and compliantly.
Why Skilled Nursing Facility Billing Requires Specialized Expertise?
Billing SNF services is a high-stakes task. There are strict CMS guidelines and payer-specific documentation requirements for every Skilled Nursing Facility CPT code.
With high denial rates for E/M services, you need a partner who knows initial SNF visit billing inside out.
That’s where Reenix Excellence comes in.
How Reenix Excellence Supports SNF Billing Success?
Whether you’re a solo provider or a multisite SNF practice, Reenix Excellence offers custom billing solutions to help you get paid — faster and more accurately.
End-to-End SNF Billing Support:
- Certified CPT and ICD-10 coding
- Claims submission and denial resolution
- Eligibility verification and benefits tracking
- Payment posting and AR management
Deep SNF Experience:
- Over 200 certified RCM professionals
- Special focus on post-acute and long-term care billing
- Experts in Medicare billing for nursing home visits
With Reenix, clients typically see:
- 30% increase in collections
- Lower denial rates
- Shorter revenue cycles
FAQ
1. What is CPT 99306 used for in SNF billing?
It’s used for an initial comprehensive visit in a Skilled Nursing Facility, involving moderate to high complexity decision-making.
2. Can CPT 99306 be billed more than once?
No. It’s billed once per admission, per provider group.
3. What documentation is required?
A full patient history, physical exam, decision-making details, and face-to-face time — all must be clearly documented.
Conclusion:
Correct use of CPT 99306 for SNF visits helps you receive proper reimbursement for the time and complexity involved in skilled nursing care. But billing success depends on much more than just knowing the code.
With expert support from Reenix Excellence, your SNF billing can move from complicated and error-prone to streamlined, accurate, and profitable.
Let’s Elevate Your SNF Billing
Don’t leave revenue on the table. If you’re managing SNF visits, let Reenix Excellence help you code correctly, submit clean claims, and increase collections.
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