CPT 0198T 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 0198T 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 0198T | ||||||
United | 0198T | $64.65 | 1104286418 - PHOENIX VAMC | 860101019 | AZ | Psychiatric Residential Treatment Facility (323P00000X) |
United | 0198T | $70.04 | 1558314948 - DALLAS VAMC, BONHAM VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $86.33 | 1003898313 - MOREHOUSE GENERAL HOSPITAL | 726011528 - (LA) MOREHOUSE GENERAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 0198T | $70.04 | 1174572416 - DALLAS VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $67.68 | 1013212448 - GUSTAVO DELGADO | 746000756 - (TX) EL PASO COUNTY HOSPITAL DISTRICT | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $85.29 | 1356320873 - EAST TEXAS MEDICAL CENTER ATHENS | 751854562 - (TX) ETX SUCCESSOR ATHENS | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $52.59 | 1003192311 - EL CAMPO MEMORIAL HOSPITAL | 452750258 - (TX) EL CAMPO MEMORIAL HOSPITAL | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $177.26 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Multi-Specialty Group (193200000X) |
United | 0198T | $177.26 | 1588098172 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | 463316332 - PROGRESSIVE EMERGENCY PHYSICIANS PLLC | NY | Emergency Medicine Physician (207P00000X) |
United | 0198T | $66.80 | 1699768705 - GONZALES HEALTHCARE SYSTEMS | 741625013 | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $51.97 | 1407191984 - BSA HOSPITAL LLC | 300754305 | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $97.83 | 1407364847 - TYLER REGIONAL HOSPITAL LLC | 823878395 | TX | General Acute Care Hospital (282N00000X) |
United | 0198T | $37.39 | 1053866707 - BRITTANY PTACHICK | 541958039 - HROA 401K PLAN | VA | Family Nurse Practitioner (363LF0000X) |
United | 0198T | $129.56 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 0198T | $60.75 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | 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 0198T vs. Other Various Services - Category III Codes Codes
The CPT 0198T 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 0198T 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 |
|---|---|---|
| 0198T-CPT | Moderate | Measurement Of Ocular Blood Flow By Repetitive Intraocular Pressure Sampling, W Interp & Report -Deny Inv/N10 Dos>= 7/14/2012 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 0198T. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 0198T 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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