CPT Code 99310: Subsequent Nursing Facility Care, High Complexity

CPT 99310 is used for subsequent nursing facility care involving high-complexity medical decision-making or when the provider spends 45 minutes or more with the patient on the facility floor. It applies to established patients in settings like skilled nursing facilities.

No. Routine or low-complexity visits should be billed using lower-level codes, such as 99307, 99308, or 99309, depending on the level of care complexity. CPT 99310 should only be used when medical necessity supports it.

Generally, no. CPT 99310 should not be billed on the same day as other E/M codes unless the services are separate and distinct, and documentation justifies both. Use modifiers (e.g., -25) if allowed by the payer.