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See a sample rate comparisonCPT 98006 Fee Schedule
Last Verified: October 2026
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.
Medical Management/Audio-Video, Synchronous Audio Video Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Medical Decision Making. When Using Total Time On The Date Of The Encounter For Code Selection 30 Minutes Must Be Met Or Exceeded.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Acupuncture Procedures |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 98006 |
| Medicaid Fee Schedule | $92.40 median of the 8 states in the free preview · View Medicaid rates for 98006 |
National average reimbursement for CPT 98006 by major payers:
$127.41
$134.91
$108.09
$326.68
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CPT 98006
5 of 25 sample ratesHigher to lower in this preview
Bevan Londergan
The Nemours Foundation
$392.09Published rateHannah Vega
University Anesthesiologists PLLC
$142.52Published rateShannon Kilkelly
Ssm Health Slu Hospital Anesthesia Physician Billing LLC
$131.16Published rateHarbans Malik
$119.81Published rateBrad Wilson
Interventional Pain Center PLLC
$91.96Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 98006 vs. Other Acupuncture Procedures Codes
The CPT 98006 code is part of the Medicine Services and Procedures services used for Acupuncture Procedures. 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 98006 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 |
|---|---|---|
| 98006-CPT | Low | Medical Management/Audio-Video, Synchronous Audio Video Visit For The Evaluation And Management Of An Established Patient Which Requires A Medically Appropriate History And/Or Examination And Moderate Medical Decision Making. When Using Total Time On The Date Of The Encounter For Code Selection 30 Minutes Must Be Met Or Exceeded. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98006. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98006 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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