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Annual Nursing Facility Assessment Visit

New York rates for HCPCS 99318

A yearly review visit by a physician or other qualified clinician for a resident of a nursing facility, covering the resident's overall condition, medicines and plan of care. It is a scheduled comprehensive review rather than a visit for a new problem.

Rates data updated October 2026.

How much rates vary

Professionalmedian $135 · 10th to 90th $135 to $135
professional $135

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
CDPHP
Setting
Professional
Modifier
None
Typical Low
$134.90
Median
$134.90
Typical High
$134.90
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Emblem Health
Setting
Professional
Modifier
GL · Free upgrade
Typical Low
$60.26
Median
$60.26
Typical High
$60.26