CPT 0098T Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Category III Codes • Various Services - Category III Codes |
| Complexity Level | Moderate |
National average reimbursement for CPT 0098T by major payers:
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| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 0098T | ||||||
United | 0098T | $10400.00 | 1659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH | 621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $2288.00 | 1861423352 - LAKE POINTE PARTNERS, LTD., LAKE POINTE MEDICAL CENTER | 260194016 - (TX) LAKE POINTE OPERATING COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $746.70 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $363.00 | 1285835561 - BIENVILLE MEDICAL CENTER INC | 743227578 | LA | Critical Access Hospital (282NC0060X) |
United | 0098T | $1593.00 | 1306281126 - UNIVERSITY HOSPITAL & CLINICS, INC., OCHSNER UNIVERSITY HOSPITAL & CLINICS | 462605366 - (LA) UNIVERSITY HOSPITAL & CLINICS INC | LA | General Acute Care Hospital (282N00000X) |
United | 0098T | $806.00 | 1245617562 - KAPLAN GENERAL HOSPITAL, INC. | 472540179 - (LA) KAPLAN GENERAL HOSPITAL INC | LA | Critical Access Hospital (282NC0060X) |
United | 0098T | $460.00 | 1649921065 - JOINT REPLACEMENT CENTER OF LOUISIANA | 874022126 - (LA) JOINT REPLACEMENT CENTER OF LOUS | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 0098T | $2500.00 | 1992707228 - SHANNON MEDICAL CENTER | 752559845 - (TX) SHANNON MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $554.00 | 1679678767 - MATAGORDA COUNTY HOSPITAL DISTRICT, MATAGORDA REGIONAL MEDICAL CENTER | 746025069 - (TX) MATAGORDA COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $341.00 | 1376540153 - ACADIA-ST. LANDRY HOSPITAL SERVICE DISTRICT, ACADIA-ST. LANDRY HOSPITAL | 720643190 | LA | Critical Access Hospital (282NC0060X) |
United | 0098T | $10586.00 | 1245201656 - TEXAS INSTITUTE FOR SURGERY, LLP, TEXAS INSTITUTE FOR SURGERY AT TEXAS HEALTH PRESBYTERIAN DALLAS | 770628004 - (TX) TEXAS INSTITUTE FOR SURGERY, LLP | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $5729.00 | 1811973100 - OCHSNER CLINIC FOUNDATION, OCHSNER MEDICAL CENTER ACUTE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | General Acute Care Hospital (282N00000X) |
United | 0098T | $11633.00 | 1629138029 - ROCKWALL REGIONAL HOSPITAL, LLC, TEXAS HEALTH PRESBYTERIAN HOSPITAL ROCKWALL | 202848116 - (TX) ROCKWALL REGIONAL HOSPITAL, LLC | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $2279.00 | 1679578439 - MOTHER FRANCES HOSPITAL REGIONAL HEALTH CARE CENTER, CHRISTUS MOTHER FRANCES HOSPITAL TYLER | 752771569 - (TX) MOTHER FRANCES HOSPITAL-WINNSBORO | TX | General Acute Care Hospital (282N00000X) |
United | 0098T | $8097.00 | 1972557957 - ST. DAVID'S HEALTHCARE PARTNERSHIP, L.P., LLP, NORTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 0098T vs. Other Various Services - Category III Codes Codes
The CPT 0098T code is part of the Category III Codes services used for Various Services - Category III Codes. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 0098T code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 0098T-CPT | Moderate | Revision Including Replacement Of Total Disc Arthroplasty (Artificial Disc) Anterior Approach; Each Additional Interspace Cervical (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0098T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0098T fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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