CPT 98013 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 | • Medicine Services and Procedures • Acupuncture Procedures |
| Complexity Level | Moderate |
National average reimbursement for CPT 98013 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 98013 | ||||||
United | 98013 | $110.94 | 1295081065 - FORREST ALLEN | 621529858 - SAINT THOMAS MEDICAL PARTNERS | TN | Interventional Pain Medicine Physician (208VP0014X) |
United | 98013 | $78.09 | 1013930494 - PRECISION PAIN CARE PLLC, DR. CHARLES GRAFFORD HILGENHURST M.D. | 203734674 - (TN) PRECISION PAIN CARE PLLC | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 98013 | $76.40 | 1396002994 - BENJAMIN BROWN | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $76.40 | 1063417673 - PATRICK FORREST | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $75.43 | 1477082469 - SAUNDRA GARRETT | 752911563 - (TX) ALLEN ANESTHESIA ASSOCIATES | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $83.04 | 1104823616 - STEPHEN SANTI | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $88.56 | 1699270686 - KYLIE PEARSON | 621123296 - (TN) UNIVERSITY ANESTHESIOLOGISTS PLLC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $93.58 | 1134553878 - FAMILY HEALTH GROUP INC | 621649052 - MAURY REGIONAL MEDICAL GROUP INC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $76.40 | 1134357718 - ARJUN DALAL | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $128.80 | 1699859710 - SILVIO SITARICH | 541871633 - CHILDREN'S SPECIALTY GROUP, PLLC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $83.04 | 1982100558 - CALVIN DAVIS | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $56.23 | 1982972857 - PROXIMA CENTAURI, PLLC, LINCOLN TREE MEDICAL CLINIC OF TULLAHOMA, PLLC | 460467100 - (TN) PROXIMA CENTAURI PLLC | TN | Pain Clinic/Center (261QP3300X) |
United | 98013 | $65.59 | 1245306232 - PRACTICE OF PAIN MANAGEMENT PLC, CUMBERLAND PAIN ASSOCIATES PLC | 621868054 - (TN) PRACTICE OF PAIN MANAGEMENT PLC | TN | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 98013 | $83.04 | 1992903504 - ANUJ ARYAL | 620931432 - (TN) ANESTHESIA MEDICAL GROUP PC | TN | Anesthesiology Physician (207L00000X) |
United | 98013 | $70.94 | 1932129400 - SEKOU MOLETTE | 621720000 | TN | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
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 98013 vs. Other Acupuncture Procedures Codes
The CPT 98013 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 98013 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 |
|---|---|---|
| 98013-CPT | Moderate | Synchronous Audio-Only Visit For The Eval &Management Of An Est Pt, Which Req A Medically Appropriate Hx And/Or Exam, More Than 10 Min Discussion, 20 Min Must Be Met Or Exceed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98013. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98013 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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