Hospital · CMS status A
99238
Hospital discharge day <= 30 min
Hospital inpatient or observation discharge day management, 30 minutes or less. CMS 2026 wRVU 1.50. The lower-effort of the two discharge codes; appropriate when discharge documentation, med reconciliation, and patient instructions can be completed in under 30 minutes.
Work RVU
1.50
2026 Medicare pays
$73.82
National GPCI · non-facility · CF $33.4009
RVU anatomyWork 1.50 + Practice 0.60 + Malpractice 0.11 = 2.21 total
Work (your effort)Practice expenseMalpractice
Billing guidance for 99238 is locked
- When to use it: the exact clinical situations that support billing 99238
- Documentation checklist: the 5 elements your note needs before submitting
- Common pitfalls: the 3 mistakes that get 99238 downcoded or denied
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Common ICD-10 pairings
J44.1I50.32N39.0
Payer notes
Medicare and commercial payers pay 99238 at the standard PFS allowable. Some payers require documentation of the time spent on discharge-day activities to support the 99239 (over 30 min) code; documentation should include the total time and qualifying activities (med rec, family discussion, PCP communication, prescription writing).
Pairs well with
Educational reference, not billing or legal advice. Verify against your payer contracts and your compliance team before submission.