CPT 98940 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 • Chiropractic Manipulative Treatment Procedures |
| Common Place of Service | • 11 - Office • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • AT - Acute or Active Treatment • GA - Required ABN issued and on file |
| Complexity Level | Low |
National average reimbursement for CPT 98940 by major payers:

$25.23

$31.34

$27.33

$38.78
| 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 98940 | ||||||
United | 98940 | $29.71 | 1679507875 - FIRAS AL SOLAIMAN | 352526373 - ACCLAIM PHYSICIAN GROUP INC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $11.97 | 1700162278 - ALABAMA HEART & VASCULAR, P. C. | 452803595 - (AL) ALABAMA HEART AND VASCULAR, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $11.59 | 1235136821 - THERESE LANGO | 272451336 | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $28.87 | 1952353153 - WILLIAM COX | 631211664 - (AL) HUNTSVILLE CARDIOVASCULAR CLINIC, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $27.05 | 1750461620 - BENJAMIN CITRIN | 814661745 - (AL) CITRIN CARDIOLOGY PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $16.05 | 1801897772 - BANKIMCHANDRA PATEL | 631171060 - (AL) NORTH ALABAMA CARDIOLOGY CENTER, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $25.97 | 1598928079 - JOHN PARKS | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $27.44 | 1801897772 - BANKIMCHANDRA PATEL | 631102774 | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $27.05 | 1992018675 - GAUTAM REDDY | 812971996 - (AL) HH HEART CENTER LLC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $26.32 | 1225412083 - AADIL LODHI | 440577118 - LESTER E COX MEDICAL CENTER | PA | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $24.62 | 1396769964 - JULIE WEBSTER | 853861695 - MUSC COMMUNITY PHYSICIANS | SC | Body Imaging Physician (2085B0100X) |
United | 98940 | $46.72 | 1245587765 - ZAKARIA ALMUWAQQAT | 260593928 | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $26.95 | 1487867172 - TAIMOOR HASHIM | 470687317 - PHYSICIANS CLINIC INC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $25.97 | 1104037027 - JOSHUA COCKRELL | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 98940 | $25.97 | 1487790481 - JAMES TRIMM | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
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 98940 vs. Other Chiropractic Manipulative Treatment Procedures Codes
The CPT 98940 code is part of the Medicine Services and Procedures services used for Chiropractic Manipulative Treatment 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 98940 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 |
|---|---|---|
| 98925-CPT | Low | Osteopathic Manipulative Treatment 1, 2 Body Regions |
| 98926-CPT | Low | Osteopathic Manipulative Treatment 3,4 Body Regions |
| 98940-CPT | Low | Chiropractic Manipulative Treatment (Cmt); Spinal, One To Two Regions |
| 98941-CPT | Low | Chiropractic Manipulative Treatment Cmt Spinal Three To Four Regions |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98940. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98940 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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