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See a sample rate comparisonHealthcare 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 99 - Other POS |
| Common Modifiers | None 95 - Telemedicine - audio and video GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 98978 |
| Medicaid Fee Schedule | View Medicaid rates for 98978 |
National average reimbursement for CPT 98978 by major payers:

$62.38

$63.75

$50.80

$375.62
Choose a payer to see a sample of rates for CPT 98978.
Aurora Medical Group Inc
Loyola University Medical Center
Rockford Health Physicians
Town Center Orthopaedic Associates, P.C.
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 98978 vs. Other Non-Face-to-Face Nonphysician Services Codes
The CPT 98978 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 98978 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, 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 |
| 98978-CPT | Low | Remote Monitoring, Remote Therapeutic Monitoring (Eg Therapy Adherence Therapy Response Digital Therapeutic Intervention); Device(S) Supply For Data Access Or Data Transmissions To Support Monitoring Of Cognitive Behavioral Therapy Each 30 Days 16-30 Days In A 30-Day Period |
| 98980-CPT | Low | Rtm Tx Mgmt 1st 20 Min, Remote Therapeutic Monitoring Treatment Management Services Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least 1 Real-Time Interactive Communication With The Patient Or Caregiver During The Calendar Month; First 20 Minutes |
| 98981-CPT | Low | Rtm Tx Mgmt Ea Addl 20 Min, Remote Therapeutic Monitoring Treatment Management Services Physician Or Other Qualified Health Care Professional Time In A Calendar Month Requiring At Least 1 Real-Time Interactive Communication With The Patient Or Caregiver During The Calendar Month Each Additional 20 Minutes (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 98978. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98978 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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