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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 10 - Telehealth in Patient's Home |
| Common Modifiers | None GP - Services delivered under an outpatient physical therapy plan of care CQ - PT services by assistant |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 98980 |
| Medicaid Fee Schedule | View Medicaid rates for 98980 |
National average reimbursement for CPT 98980 by major payers:

$58.01

$63.93

$58.66

$181.11
Choose a payer to see a sample of rates for CPT 98980.
Merrimack Valley Pediatric Associates, Inc.
Imaging & Medical Diagnostic Specialist, PA
Carolina Radiology Associates, LLC
Lone Star Circle Of Care
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 98980 vs. Other Non-Face-to-Face Nonphysician Services Codes
The CPT 98980 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 98980 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 98980. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98980 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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