CPT 98976 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 • Non-Face-to-Face Nonphysician Services |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • None • GW - Condition not related to the patient's terminal condition • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
National average reimbursement for CPT 98976 by major payers:
$64.29
$70.70
$62.66
$95.47
| 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 98976 | ||||||
United | 98976 | $40.50 | 1750646436 - OXFORD PRE OP & IMAGING CENTER LLC | 454896914 - (MS) OXFORD PRE OP IMAGING CENTER LLC | MS | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $133.36 | 1093713091 - ST FRANCIS COMMUNITY HOSPITAL, FRANCISCAN HEALTH SYSTEM | 911267921 - (WA) ST FRANCIS COMMUNITY HOSPITAL | WA | General Acute Care Hospital (282N00000X) |
United | 98976 | $105.38 | 1699726695 - NORTHWEST ARKANSAS HOSPITALS, LLC, NORTHWEST MEDICAL CENTER | 205896848 | AR | General Acute Care Hospital (282N00000X) |
United | 98976 | $63.63 | 1407221419 - NATIONAL IMAGING OF MOUNT VERNON LLC, SOUTHERN ILLINOIS IMAGING | 474707403 - (IL) NATIONAL IMAGING OF MOUNT VERNON LLC | IL | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $51.09 | 1477731073 - ST ELIZABETH SOUTHWOODS IMAGING LLC, SOUTHWOODS IMAGING CENTER | 261626482 - (OH) ST ELIZABETH SOUTHWOODS IMAGING LLC | OH | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $60.11 | 1144218462 - REGIONAL DIAGNOSTICS, LLC | 650718594 | IL | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $170.21 | 1548716665 - UPSTATE AFFILIATE ORGANIZATION, GHS CANCER INST-ANDREWS | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 98976 | $156.83 | 1548380900 - HUNTERDON MEDICAL CENTER | 221537688 - HUNTERDON MEDICAL CENTER | NJ | General Acute Care Hospital (282N00000X) |
United | 98976 | $63.63 | 1407221419 - NATIONAL IMAGING OF MOUNT VERNON LLC, SOUTHERN ILLINOIS IMAGING | 474707403 - (IL) NATIONAL IMAGING OF MOUNT VERNON LLC | IL | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $54.09 | 1609984301 - PROGRESSIVE CANCER CARE LLC | 320061469 - (IN) PROGRESSIVE CANCER CARE LLC | IN | Radiation Oncology Clinic/Center (261QX0203X) |
United | 98976 | $54.09 | 1033426622 - CLERMONT RADIOLOGY LLC | 810607616 - (FL) CLERMONT RADIOLOGY | FL | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $57.09 | 1326171364 - MRI COOPERATIVE, FORUM HEALTH DIAGNOSTICS | 341773672 | OH | Radiology Clinic/Center (261QR0200X) |
United | 98976 | $294.25 | 1073510277 - PEACEHEALTH, ST. JOHN MEDICAL CENTER | 910564987 | WA | General Acute Care Hospital (282N00000X) |
United | 98976 | $46.00 | 1144274127 - PROGRESSIVE ACUTE CARE DAUTERIVE, LLC, DAUTERIVE HOSPITAL | 364756243 - (LA) PROGRESSIVE ACUTE CARE DAUTERIVE LLC | LA | General Acute Care Hospital (282N00000X) |
United | 98976 | $99.70 | 1598971855 - OVERLAKE HOSPITAL MEDICAL CENTER LAB | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | 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 98976 vs. Other Non-Face-to-Face Nonphysician Services Codes
The CPT 98976 code is part of the Medicine Services and Procedures services used for Non-Face-to-Face Nonphysician Services. 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 98976 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 |
|---|---|---|
| 98970-CPT | Low | Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service, For An Established Patient, For Up To 7 Days, Cumulative Time During The 7 Days; 5-10 Minutes |
| 98971-CPT | Low | Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service For An Established Patient For Up To 7 Days Cumulative Time During The 7 Days; 11-20 Minutes |
| 98972-CPT | Low | Qualified Nonphysician Health Care Professional Online Digital Evaluation And Management Service For An Established Patient For Up To 7 Days Cumulative Time During The 7 Days; 21 Or More Minutes |
| 98976-CPT | Low | Remote Therapeutic Monitoring (Eg, Respiratory System Status, Musculoskeletal System Status, Therapy Adherence, Therapy Response); Device(S) Supply With Scheduled (Eg, Daily) Recording(S) And/Or Programmed Alert(S) Transmission To Monitor Respiratory System, Each 30 Days |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98976. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98976 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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