CPT 98981 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 • GP - Services delivered under an outpatient physical therapy plan of care • CQ - PT services by assistant |
| Complexity Level | Low |
National average reimbursement for CPT 98981 by major payers:
$47.66
$52.09
$47.42
$75.36
| 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 98981 | ||||||
United | 98981 | $29.68 | 1891774519 - LEON HOME HEALTH, LLC, LEON AT HOME | 261288029 | FL | Home Health Agency (251E00000X) |
United | 98981 | $32.81 | 1174078281 - DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC, ORLANDO DERMATOLOGY CENTER | 208048424 - (FL) DERMATOLOGY AND SKIN CANCER SURGERY CENTER LLC | FL | Dermatology Physician (207N00000X) |
United | 98981 | $68.44 | 1760429831 - BRUCE MADSEN | 260210091 - (OR) BRIDGEPORT EYE PHYSICIANS LLC | OR | Ophthalmology Physician (207W00000X) |
United | 98981 | $68.44 | 1760429831 - BRUCE MADSEN | 260210091 - (OR) BRIDGEPORT EYE PHYSICIANS LLC | OR | Ophthalmology Physician (207W00000X) |
United | 98981 | $60.13 | 1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 98981 | $32.81 | 1174078281 - DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC, ORLANDO DERMATOLOGY CENTER | 208048424 - (FL) DERMATOLOGY AND SKIN CANCER SURGERY CENTER LLC | FL | Dermatology Physician (207N00000X) |
United | 98981 | $50.22 | 1235122029 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 98981 | $34.52 | 1225014657 - CAROLINA RADIOLOGY ASSOCIATES LLC | 571049603 - (SC) CAROLINA RADIOLOGY ASSOCIATES, LLC | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 98981 | $69.55 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 98981 | $69.55 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 98981 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 98981 | $39.65 | 1285649095 - IMAGING PARTNERS OF MISSOURI, LLC | 870723291 - (MO) IMAGING PARTNERS OF MISSOURI LLC | MO | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $52.86 | 1053922567 - AMERICAN HEALTH IMAGING OF GEORGIA LLC, AMERICAN HEALTH IMAGING OF SAVANNAH, LLC | 582388975 | GA | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $48.75 | 1144729716 - ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDER, HSHS IMAGING CENTER,BELLEVILLE | 370663567 - (IL) ST ELIZABETHS HOSPITAL OF THE HOSPITAL SISTERS OF THE THIRD ORDE | IL | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $48.75 | 1942570981 - ONE STEP DIAGNOSTIC IX LP | 452769053 - (TX) ONE STEP DIAGNOSTIC IX LP | TX | Radiology Clinic/Center (261QR0200X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 98981 vs. Other Non-Face-to-Face Nonphysician Services Codes
The CPT 98981 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 98981 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 |
| 98975-CPT | Low | Remote Therapeutic Monitoring (Eg, Respiratory System Status, Musculoskeletal System Status, Therapy Adherence, Therapy Response); Initial Set-Up And Patient Education On Use Of Equipment |
| 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 |
| 98981-CPT | Low | Remote Therapeutic Monitoring Treatment Managemen Services Physician Or Other Qualified Health Car Professional Time In A Calendar Month Requiring A Least One Interactive Communication With The Pa- Tient 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 98981. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 98981 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 98981) and we'll show you how you compare in 15 minutes or less.