The 99344 CPT code reports a home or residence evaluation and management (E/M) visit for a new patient. A visit qualifies with moderate medical decision making (MDM) or at least 60 minutes of total time on the date of the encounter, with travel excluded. Medicare doesn’t require the patient to be homebound.
CPT 99344 is active for 2026 dates of service. Medicare’s 2026 national rate is $146.63 at the standard conversion factor, and Medicare has paid the G2211 add-on with it since January 1, 2026. MACs turned on the matching claim edits under CR 14447 on October 5, 2026.
Several pages that rank for the 99344 CPT code still list 99343, a POS 12 only rule, or a prolonged service add-on for 99344. Payers deny claims built on any of those errors, so check the date and source on a reference before you rebuild a template around it.
99344 CPT Code at a Glance (2026)
| Item | 2026 detail |
|---|---|
| Code family | Home or residence services, new patient (99341, 99342, 99344, 99345) |
| Patient status | New: no professional service from you or a same-specialty colleague in your group within three years |
| Level selection | Moderate MDM, or total time on the date of the encounter |
| Time rule | 60 minutes or more of total time; travel doesn’t count |
| Settings and POS | Home (12), assisted living facility (13), group home (14), custodial care facility (33), residential substance abuse treatment facility (55) |
| Status | Active for 2026; revised January 1, 2023, when the AMA deleted 99343 |
| 2026 Medicare rate | $146.63 (non-QP); $147.36 (QP); $124.64 for NPs and PAs at 85% |
| RVUs | 2.87 work, 1.36 practice expense, 0.16 malpractice, 4.39 total |
| Global period | XXX |
| G2211 add-on | Payable since January 1, 2026; $17.37 at the national rate |
| Prolonged time | None with 99344; Medicare’s G0318 starts with 99345 at 140 minutes |
| Telehealth | On the CY 2026 Medicare Telehealth Services List; POS 10 when the patient is at home, through December 31, 2027 |
| Homebound | Not required |
Sources: AMA CPT E/M guidelines; CMS MLN006764 (May 2026); CMS RVU26D (October 2026 release).
What Is the 99344 CPT Code? Official Description and Purpose
CPT code 99344 is the new patient home visit CPT code for moderate complexity, one of four live codes in the series. It sits above 99342 (low MDM) and below 99345 (high MDM). You’ll reach for it on a first home visit with a patient whose active problem needs a management decision.
The Official 99344 CPT Code Description
The AMA’s descriptor, revised January 1, 2023, defines 99344 as a home or residence E/M visit for a new patient. It requires a medically appropriate history or exam and a moderate level of MDM. If you select the level by time, the descriptor says 60 minutes “must be met or exceeded.”
That wording sets a floor of 60 minutes and no ceiling. The 74-minute cap on some reference sites comes from the next code up, since 75 minutes of total time supports 99345. You can read the full code set in the AMA’s 2023 E/M guidelines.
What Each Part of the Descriptor Means on a Claim
Auditors read the note against each phrase of the descriptor, so each phrase carries a billing consequence. Use this table to check a note before the claim goes out.
| Descriptor phrase | What it means for billing |
|---|---|
| Home or residence | The patient lives in one of five residential settings, and the POS code on the claim matches that setting. |
| New patient | The patient hasn’t received a professional service from you or a same-specialty colleague in your group within three years. |
| Medically appropriate history and/or examination | You document what the problem calls for, and the extent of that work doesn’t set the level. |
| Moderate level of medical decision making | Two of the three MDM elements reach moderate. |
| 60 minutes must be met or exceeded | Total time on the date of service reaches at least 60 minutes, with travel left out. |
What Kind of Visit 99344 Describes
A 99344 visit is the first home encounter with a patient whose problems call for a management decision. Picture a homebound new patient with atrial fibrillation whose heart rate keeps running fast. The physician adjusts the rate-control medication and reconciles the medication list. That’s a chronic illness with exacerbation plus prescription drug management.
Both of those elements reach moderate, which puts the visit at 99344 without counting minutes. House call practices, home-based primary care groups, and clinicians who round in assisted living facilities bill this code. Specialists can bill it too, as long as the patient is new to their specialty within the group.
Is CPT 99344 Still Valid in 2026?
Yes. CPT 99344 is active for 2026 dates of service. The AMA revised it on January 1, 2023, and CMS pays it under the CY 2026 Physician Fee Schedule, with values carried in the October 2026 RVU26D file.
What Changed for the 99344 CPT Code Since 2021
The 2021 E/M overhaul changed office visit codes and left home visit codes alone. Those kept the three-key-component rules until January 1, 2023. That’s why 2021 and 2022 references for 99344 still call for a comprehensive history and a comprehensive exam. A template that asks for both predates the current rules.
| Element | 2021 and 2022 | 2023 to 2026 |
|---|---|---|
| Level selection | Three key components: comprehensive history, comprehensive exam, and moderate MDM | Moderate MDM or total time |
| Time | Typical face-to-face time | 60 minutes of total time on the date of service, travel excluded |
| Settings | Private residence; other residences used domiciliary codes | Five residential settings in one code family |
| G2211 | Not payable | Payable since January 1, 2026 |
What Replaced 99343?
No single code replaced 99343. The AMA deleted the 99343 CPT code on January 1, 2023, and points coders to 99341, 99342, 99344, or 99345, chosen by MDM or time. For a family medicine view of the same merger, see the AAFP’s home visit coding update.
A visit that used to fit 99343 at moderate MDM now lands on 99344. If you bill by time and the total falls between 30 and 59 minutes, follow the rules for 99342 low MDM home visits instead. Use this crosswalk to clean up old superbills and pick lists:
| Deleted code | Report instead |
|---|---|
| 99343 | 99341, 99342, 99344, or 99345 |
| 99324 to 99328 | 99341 to 99345 |
| 99334 to 99337 | 99347 to 99350 |
| 99339 and 99340 | Care management codes 99437 or 99491, or principal care management codes 99424 or 99425 |
Payers reject CPT code 99343 on any date of service from 2023 forward, often with CARC 181, and they reject CPT 99324 the same way. If an old superbill still shows the 99343 CPT code description, replace that line with the four live home visit CPT codes today.
Who Counts as a New Patient for 99344?
A patient is new for 99344 when neither you nor a practitioner of the exact same specialty and subspecialty in your group has provided a professional service to that patient within three years. Run that test before you score MDM. It decides whether you’re picking a CPT code for new patient home visits or an established one.
Three New Patient Traps on Home Visits
Three situations trip up home visit coders on a regular basis, and each one turns on that same-specialty, same-group test:
- Your group’s internist saw the patient in the office two years ago, and another internist from the group makes the home visit. The patient is established, so bill 99349.
- A cardiologist in your multispecialty group saw the patient last year, and an internist makes the home visit. The patient is still new to internal medicine, so 99344 can apply.
- A nurse practitioner saw the patient last year, and a physician of the same specialty makes the home visit. The AMA counts NPs and PAs as the physician’s specialty, so the patient is established.
Covering for a colleague doesn’t change the answer, because the AMA classifies the visit the way the absent practitioner would have. Multispecialty groups run into trap two the most, which is why group practice billing teams check each rendering provider’s enrolled specialty before coding.
Is There an Established Patient Version of CPT 99344?
No. Searches for a CPT 99344 established patient code come from a common mix-up: the established code at the same moderate level is 99349, which needs moderate MDM or 40 minutes. Bill 99349 any time the three-year test turns up a same-specialty visit in your group.
Who Can Bill 99344
Physicians, nurse practitioners, physician assistants, and clinical nurse specialists can bill 99344 under their own NPI when state scope of practice allows E/M services. Incident-to billing doesn’t fit a new patient visit, because incident-to requires a plan of care the supervising physician already established.
Each rendering NPI needs active enrollment with every payer before that clinician’s first home visit claim. If NPs on your home visit team are still waiting on enrollment, our provider credentialing and enrollment team tracks each payer application so the first 99344 claim goes out under an active NPI.
Where You Can Bill 99344: Settings and Place of Service Codes
CMS lists five place of service (POS) codes for the 99341 to 99350 family in CMS’s E/M services booklet. Report the 99344 CPT code with the POS that matches where the patient lives. Your office address plays no part in that choice.
| POS | Setting | Example |
|---|---|---|
| 12 | Home | Private house or apartment |
| 13 | Assisted living facility | Resident in an assisted living apartment |
| 14 | Group home | Group home not licensed as an intermediate care facility for individuals with intellectual disabilities (ICF/IID) |
| 33 | Custodial care facility | Residential setting providing room, board, and personal care |
| 55 | Residential substance abuse treatment facility | Live-in treatment program |
CPT’s definition of home includes temporary lodging such as a hotel or cruise ship. Medicare’s POS list for this family doesn’t include POS 16 for temporary lodging, though, so check the payer’s policy before you bill a hotel visit. Our guide to POS 12 billing rules covers the private residence setting.
Assisted Living: The CPT Code for Assisted Living After 2023
Since January 1, 2023, assisted living residents get the same codes as private homes: 99341 to 99350, reported with ALF POS 13. Payers now deny the old assisted living CPT codes, 99324 to 99337, as invalid. Report the facility’s address as the service location in Item 32 of the CMS-1500, or Loop 2310C on the 837P.
Settings That Don’t Use 99344
Some settings look residential but belong to other code families, so a 99344 billed there draws a denial. Send these visits to the codes below:
- Nursing facility and skilled nursing facility residents use 99304 to 99310, with POS 31 or 32.
- Residents of an ICF/IID or a psychiatric residential treatment center use the nursing facility codes, per the AMA.
- Hospital inpatients use the hospital inpatient codes, starting with 99221 to 99223 for the first visit.
Physical Presence and the Inpatient Overlap Audit
An in-person CPT 99344 visit puts the practitioner inside the residence, and Noridian’s home visit guidance says the physician must be physically present. One line on that page ties home visits to POS 12. CMS MLN006764 (May 2026) lists all five POS codes for this family, so use the code that matches the residence.
Medicare’s recovery auditors run RAC topic 0011, an automated review at all A/B MACs that flags home visit codes, 99344 included, billed during a hospital inpatient stay. Before you submit, check admission dates for any new patient with a recent hospital stay. A morning visit and an evening admission on the same date can still trip the edit.
How to Qualify a Visit for 99344: Moderate MDM or 60 Minutes
A home visit qualifies for CPT 99344 through moderate MDM or 60 minutes of total time, and either pathway works on its own. The note still needs a medically appropriate history and exam. Since 2023, neither one sets the level.
Moderate Medical Decision Making: The Two-of-Three Rule
MDM has three elements: the problems you address, the data you review and analyze, and the risk of the management plan. The AMA requires two of the three to meet or exceed moderate. You’ll find the moderate column of the AMA’s MDM table below:
| Element | What counts as moderate |
|---|---|
| Problems addressed | One or more chronic illnesses with exacerbation, progression, or side effects of treatment; two or more stable chronic illnesses; one undiagnosed new problem with uncertain prognosis; one acute illness with systemic symptoms; or one acute complicated injury |
| Data reviewed and analyzed | One of three categories: (1) any three of external notes from each unique source, each unique test result reviewed, each unique test ordered, or an independent historian; (2) independent interpretation of a test performed by another practitioner; (3) discussion of management with an external physician or appropriate source |
| Risk of patient management | Examples: prescription drug management; a decision about minor surgery with patient or procedure risk factors; a decision about elective major surgery without risk factors; diagnosis or treatment significantly limited by social determinants of health |
Stable has a narrow meaning in this table. A patient who isn’t at the treatment goal isn’t stable, even when nothing changed since the last reading. The AMA groups a poorly controlled chronic illness with exacerbation and progression, so uncontrolled diabetes reaches moderate on the problem element.
Coders trip on the data element when they treat one record review as enough. Category 1 needs three items in any combination, such as one outside note, one lab result, and one test order. A hospital discharge summary reviewed by itself leaves data below the low level.
The 99344 CPT Code Time Rule: 60 Minutes, Travel Excluded
Total time means your own time on the date of the encounter, with or without the patient in front of you. The AMA counts these activities toward it:
- Preparing for the visit, such as reviewing test results
- Obtaining or reviewing history that someone else gathered
- Performing a medically appropriate exam
- Counseling the patient, family, or caregiver
- Ordering medications, tests, or procedures
- Talking with other clinicians when you don’t bill that call separately
- Documenting the visit in the record
Leave out travel, time on services you bill on their own line, general teaching, and clinical staff time. CMS MLN006764 adds that Medicare wants the full 60 minutes. The CPT midpoint rule doesn’t apply here, so 58 minutes won’t support 99344 by time.
Time Ladder for New Patient Home Visits
Time alone moves a new patient home visit up one level at each threshold. Read the ladder from your documented total, then compare it with the level your MDM supports.
| Total time on date of service | Code |
|---|---|
| 15 to 29 minutes | 99341 |
| 30 to 59 minutes | 99342 |
| 60 to 74 minutes | 99344 |
| 75 minutes or more | 99345 |
| Medicare, 140 minutes or more | 99345 plus G0318 |
| CPT-rule payers, 90 minutes or more | 99345 plus 99417 |
The 60 to 74 minute band is a time-only range. Nothing in the 99344 descriptor caps the visit at 74 minutes. At 75 minutes, time supports 99345 instead, so the band ends where the next code begins.
Score Both Pathways Before You Pick the Level
Score MDM and time on each note, then bill the higher level that either one supports. Take a 45-minute visit with moderate MDM: it bills as 99344 on MDM. A 62-minute visit with low MDM reaches 99344 through the time pathway, and both claims hold up when the note shows the work.
Write the time statement even when MDM carries the visit. If an auditor scores your MDM one level lower, a documented 64 minutes can still hold the code. A line like this one works:
| Total time on date of service: 64 minutes. Includes 15 minutes reviewing hospital discharge records, 38 minutes face to face with the patient and daughter, and 11 minutes documenting and coordinating with the pharmacy. Travel time excluded. |
Coding a moderate visit as 99342 costs $67.80 per visit at the 2026 national rate. If you’d like a second set of eyes on these notes, our home visit coding review checks each one against the MDM table before the claim goes out.
99344 vs 99342, 99345, 99349, and 99204: Choosing the Right Code
The 99344 code sits beside four codes close enough to cause errors. Two share its setting at different MDM levels, one shares its MDM level for established patients, and one shares it in the office. Picking the right new patient home visit CPT code comes down to MDM, time, and patient status.
| Code | Patient | Setting | MDM | Minimum time |
|---|---|---|---|---|
| 99342 | New | Home | Low | 30 minutes |
| 99344 | New | Home | Moderate | 60 minutes |
| 99345 | New | Home | High | 75 minutes |
| 99349 | Established | Home | Moderate | 40 minutes |
| 99204 | New | Office | Moderate | 45 minutes |
Established patient home visits use 99347 to 99350; see our guide to established patient home visits for the full series.
99344 vs 99342: The 30 to 59 Minute Gap
A visit with low MDM stays at 99342 until total time reaches 60 minutes, however far it runs past 30. The two codes sit $67.80 apart at the 2026 national Medicare rate, $146.63 against $78.83. Undercoding 15 moderate visits a month as 99342 gives up $12,204 a year.
We calculated that figure from the national fee schedule, and your locality and payer mix will move it. The point holds either way: score MDM before you default to the lower code on a long visit with a simple problem.
99344 vs 99345: When Moderate Becomes High
The 99345 CPT code description matches 99344 except for two points: high MDM and a 75-minute threshold. High MDM needs two of three elements at high. Examples include a chronic illness with severe exacerbation, a decision about hospitalization, and drug therapy that requires intensive monitoring for toxicity.
Document a hospitalization decision in plain words when your clinician makes one. A note that says the physician weighed admission against treatment at home supports high risk. If the note leaves that decision out, risk stays at moderate and the visit stays at 99344.
99344 vs 99349: New vs Established at the Moderate Level
Both codes need moderate MDM. The 99349 CPT code description sets its time threshold at 40 minutes, while 99344 needs 60. Patient status decides between them, and our CPT 99349 billing guide covers the established side in depth.
99344 vs 99204: Home vs Office at the Same Complexity
Office code 99204 also requires moderate MDM, at 45 minutes instead of 60. The place of service decides the code family. An office E/M code billed with POS 12 draws a code-to-POS mismatch denial, and our 99204 office visit rules guide covers the office side.
Three Home Visit Scenarios
Scenario one. A new patient with Parkinson’s disease has fallen twice this month. The physician reviews the outside neurology note, adjusts the carbidopa-levodopa schedule, and refers the patient to physical therapy. A chronic illness with progression and prescription drug management both reach moderate. Result: 99344.
Scenario two. A new patient in assisted living reports burning with urination and has no fever. The nurse practitioner orders a urinalysis, starts an antibiotic, and spends 35 minutes on the visit. MDM lands at low despite the prescription, because the problem stays at low. Result: 99342.
Scenario three. A new patient with COPD is short of breath at rest, with oxygen saturation in the 80s. The physician weighs hospital admission against treatment at home and documents that decision. Severe exacerbation and the hospitalization decision both reach high. Result: 99345.
99344 Documentation Requirements and Medical Necessity
A defensible note for CPT code 99344 answers three questions for an auditor: why you saw the patient at home, what supports moderate MDM or 60 minutes, and who performed the visit. Good clinical care won’t save a note that leaves one of those questions open.
What a 99344 Note Must Show
- Date of service and exact location, with an address or facility name that matches the POS on the claim
- New patient status, with no same-specialty service from your group within three years
- Chief complaint and the reason the visit happened at home
- A medically appropriate history and exam for the problems addressed
- MDM elements at moderate, or exact total minutes with activities listed and travel excluded
- Assessment and plan for each problem addressed
- Signature and credentials of the practitioner who was present, matching the rendering NPI
The first two items start before the visit. Running insurance eligibility verification at scheduling confirms coverage and pulls the visit history you need for the three-year test.
Medical Necessity for a Home Visit
Noridian’s home visit guidance spells out what a reviewer looks for in each note. Use these five points as the checklist for your template:
- A chief complaint or specific need for each visit
- An active problem, since an inactive or chronic condition alone doesn’t establish necessity
- A visit frequency close to what the patient would need in an office
- A service that a visiting nurse or home health agency couldn’t provide
- A medical reason the visit happened at home, since Noridian treats a convenience visit as a social visit
Homebound status isn’t part of this test. That rule belongs to the Medicare home health benefit. Your note still needs one plain sentence on why the patient couldn’t come in, such as “uses a walker, can’t manage the clinic stairs, and has no ride.”
Diagnosis Codes That Support the Home Setting
List the condition you treated first. Then add a status code that explains why the patient couldn’t travel, when one applies. Each code below is valid in the FY2027 ICD-10-CM set that took effect October 1, 2026.
| ICD-10-CM | Description |
|---|---|
| Z74.09 | Other reduced mobility |
| Z99.3 | Dependence on wheelchair |
| Z91.81 | History of falling |
| Z59.82 | Transportation insecurity |
Sample 99344 Note (MDM Pathway)
This illustrative note describes no real patient. It shows a visit that bills 99344 on MDM at 52 minutes, which falls below the time threshold, so the MDM documentation carries the whole claim.
| Setting: Assisted living facility, POS 13. New patient to the practice.CC: Facility staff report fingerstick glucose readings above 300 for one week.Reason for home visit: Patient uses a wheelchair (Z99.3) and needs a two-person assist for transport.Data: Reviewed the hospital discharge summary from March 2026. Reviewed the facility lab report with an A1c dated September 2026. Ordered a basic metabolic panel.Assessment: Type 2 diabetes with hyperglycemia (E11.65), above goal. COPD (J44.9), stable on the current inhaler.Plan: Increased metformin dose. Glucose checks twice daily by facility staff. Recheck in two weeks.MDM: Moderate. Chronic illness with progression, three Category 1 data items, and prescription drug management.Total time on date of service: 52 minutes, travel excluded. |
99344 CPT Code Reimbursement in 2026: RVUs, Rates, and NPP Payment
Medicare’s 2026 national payment for CPT 99344 is $146.63 for clinicians paid at the non-QP conversion factor and $147.36 for qualifying APM participants (QPs), before locality adjustment. CMS set two conversion factors for 2026: $33.4009 for non-QP clinicians and $33.5675 for QPs.
| Component | Value |
|---|---|
| Work RVU | 2.87 |
| Practice expense RVU | 1.36 |
| Malpractice RVU | 0.16 |
| Total RVU | 4.39 |
| Non-QP payment | 4.39 x $33.4009 = $146.63 |
| QP payment | 4.39 x $33.5675 = $147.36 |
Confirm these values in the CMS RVU26D relative value file, the October 2026 release, when you load your fee schedule. CMS updates that file each quarter, so a fee schedule built in January can drift by October.
What Your Practice Collects
Medicare adjusts each RVU by your locality’s geographic practice cost index (GPCI), so the national figure moves up or down by region. NPs and PAs billing under their own NPI receive 85% of the fee schedule amount, which comes to $124.64 at the national rate.
Medicare pays 80% of the allowed amount after the Part B deductible, and the patient owes 20% coinsurance. CMS assigns non-facility values to this whole family, so an assisted living visit and a private home visit pay the same base amount.
A paid claim can still be a short-paid claim. Compare each remittance against your expected allowed amount, and flag the gap while the appeal window is open. Our payment posting and reconciliation team runs that comparison line by line on each 835.
Why Other Sources Show Different 99344 Rates
Some published rates for 99344 run on a prior-year conversion factor or older RVU inputs, and at least one calculator labels the code high complexity. Check the year and the RVU inputs whenever two published numbers disagree. A rate without its inputs gives you nothing to verify.
Commercial and Medicare Advantage Rates
Commercial plans and Medicare Advantage plans set 99344 rates by contract, often as a percentage of Medicare. Prior authorization rules and G2211 recognition vary by plan too. Pull the fee schedule attached to each contract instead of assuming it mirrors Medicare.
G2211 With 99344: The 2026 Add-On and the Modifier 25 Exception
Starting January 1, 2026, Medicare pays add-on code G2211 with CPT code 99344, per the CMS CY 2026 final rule summary. The practitioner has to serve as the patient’s continuing focal point for care or manage a single serious or complex condition over time.
Can a First Home Visit Qualify for G2211?
Yes, a first home visit can carry G2211 when it starts an ongoing care relationship and the note documents that relationship in the plan. A home-based primary care practice that takes over a new patient’s care meets the test. One-time evaluations with no planned follow-up don’t, even at moderate complexity.
G2211 pays $17.37 at the 2026 national rate, which brings 99344 plus G2211 to $164.00. Record the relationship in the plan with a line such as “practice assumes primary care; monthly home visits planned.”
The Modifier 25 Rule for G2211 on Home Visits
Medicare denies G2211 when the base code carries modifier 25. The exception covers a same-day annual wellness visit (AWV), vaccine administration, or Part B preventive service, and CMS extended that exception to home or residence visits for 2026.
| Claim lines | G2211 result |
|---|---|
| 99344-25 + AWV, vaccine administration, or Part B preventive service + G2211 | Payable |
| 99344-25 + minor procedure + G2211 | Denied |
Claims Denied Before October 5, 2026
CR 14447 made the policy effective January 1, 2026, but MACs didn’t implement the claim edits until October 5, 2026, per CMS transmittal R13753. Pull G2211 denials on home visits dated January 1 through October 4, and ask your MAC about reprocessing.
Some scrubbers also strip G2211 from home visit lines because the add-on used to pair with office codes alone. Our revenue cycle management team builds a G2211 check into charge review, so qualifying 99344 CPT code claims carry the add-on.
Same-Day Services, Prolonged Time, and Telehealth With 99344
Billing Other Services the Same Day as 99344
CPT 99344 can share a date of service with other work when the note supports a significant, separately identifiable visit. These rules come up on home visit claims:
- Modifier 25 goes on 99344 when you also bill a procedure, an AWV, or a preventive service that day.
- Advance care planning (99497) done with an AWV takes modifier 33, which waives the patient’s cost sharing.
- Chronic care management can bill in the same month if the CCM minutes exclude the visit time.
- A visit that serves as the transitional care management (TCM) face-to-face visit belongs to 99495 or 99496.
- Modifier 59 doesn’t belong on an E/M code.
- A second home visit from your group to the same patient is established and bills as 99347 to 99350.
The TCM rule matters most when the same clinician handles the post-discharge follow-up and the first home visit. Our guide to TCM code 99496 covers the face-to-face timing and the 30-day period.
Why Prolonged Service Codes Don’t Attach to 99344
Prolonged service codes attach to 99345 and 99350, the top levels in each home series. A long visit at moderate complexity moves up to 99345 at 75 minutes instead. Payers that follow CPT allow 99417 starting at 90 minutes with 99345.
Medicare uses its own code. The G0318 CPT code description time rule requires 140 minutes with 99345, counted from three days before the visit through seven days after it, per CMS MLN006764. Our 99417 prolonged service rules guide covers the CPT side.
Can CPT 99344 Be Billed via Telehealth?
Yes, under Medicare’s 2026 rules. CPT 99344 appears on the CMS telehealth services list for CY 2026. Medicare patients can receive telehealth at home through December 31, 2027, per HHS telehealth policy updates.
Report POS 10 when the patient is at home and POS 02 when the patient is somewhere else, per the CMS telehealth FAQ (February 2026). Home telehealth claims pay at the non-facility rate. Medicare allows audio-only visits at home through December 31, 2027 when the patient can’t or won’t use video, with modifier 93.
A video visit can’t carry POS 12, because POS 12 requires you in the room. Commercial plans keep their own telehealth lists and modifier rules, so check each contract before you bill the 99344 CPT code by video.
Common 99344 Denials and Audit Risk
CMS reports a 10.3% improper payment rate across all E/M codes for the 2024 reporting period, about $3.9 billion, per CMS E/M compliance tips. Incorrect coding drove 49.1% of it, insufficient documentation 34.1%, and no documentation 13.1%.
The same three causes show up on home visit claims. Each 99344 denial in this table ties to one fixable error:
| Denial | Likely cause on a 99344 claim | Fix |
|---|---|---|
| CARC 181 | 99343 or a deleted domiciliary code on the claim | Recode to 99341, 99342, 99344, or 99345 |
| CARC 5 or 58 | POS doesn’t match the code or the residence | Correct the POS to 12, 13, 14, 33, or 55 and resubmit |
| CARC 50 | Note doesn’t explain the home setting | Appeal with records, then fix the template |
| Recoupment on review | Patient was established | Rebill as 99347 to 99350 |
| RAC 0011 overlap | Visit dated during an inpatient stay | Verify admission dates and void the line |
| CARC 16 with RARC N290 | Rendering NPI missing or invalid | Correct the rendering NPI and resubmit |
| G2211 denied | Modifier 25 without a qualifying preventive service | Remove G2211 or correct the modifier |
Home Visit Denial Triggers Noridian Lists
Noridian’s home visit page names specific patterns that draw a denial on review. Four of them show up on new patient visits:
- The record doesn’t show who requested the visit.
- Visit frequency runs higher than office care for the same problem would need.
- The physician solicited the visit instead of the patient or caregiver requesting it.
- Another provider already treats the same diagnosis.
Answer the first two inside the note itself. Name the person who asked for the visit, and explain why the visit frequency fits the problem you’re treating.
Appeal Timing
A Medicare redetermination, the first appeal level, has to reach the MAC within 120 days of the date you receive the initial determination. Clerical errors, such as a wrong POS, go through a reopening instead of an appeal.
Repeat denials point to a break upstream of the claim. Our denial management services team sorts home visit denials by root cause. Balances that age past 60 days go to our aged AR follow-up team, which works them before filing limits close.
99344 CPT Code Pre-Bill Checklist
Run these eight checks before a 99344 claim leaves the practice. Each check lines up with one of the denial causes in the table above.
- Confirm new patient status, with no same-specialty group visit in three years.
- Match the POS to the residence and rule out an inpatient stay that day.
- Confirm moderate MDM or 60 minutes of total time, travel excluded.
- Confirm a chief complaint and a documented reason for the home visit.
- Bill under the NPI of the practitioner who was present, enrolled and reassigned to your group.
- Add G2211 when an ongoing care relationship starts, and check modifier 25 first.
- Check the current quarter’s NCCI edits for any same-day service.
- Remove 99343 and the deleted domiciliary codes from charge masters and pick lists.
We run these eight checks as pre-submission claim edits for home visit practices, so a miss lands in a coder’s work queue before a payer sees the claim.
99344 CPT Code FAQs
What is CPT code 99344?
CPT code 99344 is a home or residence E/M visit for a new patient that requires moderate MDM or at least 60 minutes of total time. It covers private homes, assisted living facilities, group homes, custodial care facilities, and residential substance abuse treatment facilities. The code is active for 2026, and established patients use 99347 to 99350 instead.
What is the 99344 CPT code description?
The 99344 CPT code description calls for a medically appropriate history or exam and moderate MDM, or 60 minutes of total time on the date of the encounter, travel excluded. AMA wording makes 60 minutes a floor. You’ll see a 60 to 74 minute range online because 75 minutes qualifies the visit for 99345.
Who can be billed under code 99344?
New patients qualify for 99344, meaning no professional service from you or a same-specialty colleague in your group within three years. Physicians, NPs, PAs, and clinical nurse specialists bill it under their own NPI. Patients seen inside that window are established and use 99347 to 99350, though a visit from a different specialty in the group doesn’t count.
What are the new patient home visit codes 99341 to 99345?
The new patient home visit series has four live codes: 99341, 99342, 99344, and 99345. Code 99341 needs straightforward MDM or 15 minutes, 99342 needs low MDM or 30 minutes, 99344 needs moderate MDM or 60 minutes, and 99345 needs high MDM or 75 minutes. The AMA deleted 99343 on January 1, 2023, which leaves a gap in the range.
Can I bill CPT 99344 on the same day as another service?
Yes. Code 99344 can go on the same claim as a procedure, AWV, or preventive service when the note supports a separate, significant visit and you append modifier 25. G2211 still pays with 99344-25 if the other service is an AWV, vaccine administration, or Part B preventive service. A TCM face-to-face visit can’t also bill as 99344.
What is the 99344 CPT code time requirement?
The 99344 CPT code time requirement is 60 minutes of total practitioner time on the date of the encounter. Total time includes preparation, the visit, counseling, orders, care coordination, and documentation on that date. Travel, clinical staff time, and separately billed services don’t count. Medicare requires the full 60 minutes, so 59 minutes won’t support the code by time.
How much does Medicare pay for 99344 in 2026?
Medicare’s 2026 national rate for 99344 is $146.63 at the non-QP conversion factor and $147.36 for qualifying APM participants, before locality adjustment. NPs and PAs billing under their own NPI receive 85%, or $124.64. Adding G2211 for a qualifying visit brings the total to $164.00, and the patient owes 20% coinsurance after the Part B deductible.
What replaced CPT 99343?
No single code replaced CPT 99343. The AMA deleted it on January 1, 2023, and new patient home visits now use 99341, 99342, 99344, or 99345, chosen by MDM or time. A moderate visit that once fit 99343 bills as 99344 today. Payers deny claims that still carry 99343, often with CARC 181, so remove it from charge masters.
Can 99344 be billed in assisted living?
Yes. Since January 1, 2023, the CPT codes for assisted living facility visits are the home or residence codes, 99341 to 99350, including 99344, reported with POS 13. Payers deny the old domiciliary codes, 99324 to 99337, as invalid. Residents of a nursing facility or skilled nursing facility use 99304 to 99310 instead, so confirm the facility’s licensure first.
Does a patient need to be homebound for 99344?
No. Medicare doesn’t require homebound status for 99344 or any other home or residence E/M visit. Homebound status belongs to the home health benefit, which pays home health agencies. Your note still has to show a medical reason for the home visit, such as limited mobility or no reliable transportation, or a reviewer can treat it as a social visit.
Can CPT 99344 be billed via telehealth?
Yes, for Medicare in 2026. CPT 99344 is on the CY 2026 Medicare Telehealth Services List, and patients can receive telehealth at home through December 31, 2027. Use POS 10 when the patient is at home and POS 02 elsewhere. An in-person visit with POS 12 requires the practitioner in the residence, and commercial payers set their own telehealth rules.
Getting 99344 Claims Paid on the First Submission
Three fixes recover the most money on the 99344 CPT code claims we review. Score MDM and time together on each note, match POS, rendering NPI, and patient status before submission, and capture G2211 where the care relationship qualifies. A missed G2211 by itself costs $17.37 per visit at the national rate.
ClaimMax RCM bills home and residence visits for house call practices and assisted living rounding groups. If you’d like a second look at last quarter’s new patient home visit CPT code claims, talk to our billing team.
Sources
- AMA, CPT Evaluation and Management (E/M) Code and Guideline Changes, effective January 1, 2023
- CMS, Evaluation and Management Services (MLN006764), May 2026
- CMS, MLN Matters MM14315, CY 2026 Physician Fee Schedule Final Rule Summary
- CMS, Transmittal R13753CP (CR 14447), May 7, 2026
- CMS, Physician Fee Schedule Relative Value File RVU26D, October 2026 release
- CMS, List of Telehealth Services
- CMS, Telehealth FAQ, updated February 26, 2026
- HHS, Telehealth Policy Updates, updated February 5, 2026
- CMS, Medicare Provider Compliance Tips: Evaluation and Management Services (2024 reporting period)
- CMS, Approved RAC Topic 0011: Home Visit E/M Codes During Inpatient Stays
- Noridian JE Part B, Home and Domiciliary Visits
- AAFP, Coding for E/M Home Visits, January 19, 2023
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