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 |
| Medicare Fee Schedule | View Medicare rates for 98981 |
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 | $68.44 | 1760429831 - BRUCE MADSEN | 260210091 - (OR) BRIDGEPORT EYE PHYSICIANS LLC | OR | Ophthalmology Physician (207W00000X) |
United | 98981 | $44.06 | 1144218462 - REGIONAL DIAGNOSTICS, LLC | 650718594 | IL | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $25.44 | 1306380951 - VILLAPARK MEDICAL IMAGING INC | 812401668 - (IL) VILLAPARK MEDICAL IMAGING INC | IL | 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 | $84.91 | 1053744888 - ASHLEY O'CONNOR | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Pediatric Nurse Practitioner (363LP0200X) |
United | 98981 | $41.00 | 1932595691 - DYNAMIC PHYSICAL THERAPY LLC | 542051136 - DYNAMICS PHYSICAL THERAPY | UT | Physical Therapy Clinic/Center (261QP2000X) |
United | 98981 | $39.65 | 1578605994 - IMAGING CENTER OF ALTON, LLC | 208303410 - (IL) IMAGING CENTER OF ALTON LLC | IL | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $30.84 | 1770579732 - VYMED DIAGNOSTIC IMAGING TAMPA LLC, NATIONAL IMAGING SPECIALISTS | 200881710 - (FL) VYMED DIAGNOSTIC IMAGING TAMPA LLC | FL | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $41.00 | 1932595691 - DYNAMIC PHYSICAL THERAPY LLC | 473188218 - DYNAMIC PHYSICAL THERAPY, LLC | UT | Physical Therapy Clinic/Center (261QP2000X) |
United | 98981 | $41.00 | 1548290943 - BUFFALO REHAB GROUP PHYSICAL THERAPY AND OCCUPATIONAL THERAPY PC | 161379851 - BUFFALO REHAB GROUP | NY | Physical Therapist (225100000X) |
United | 98981 | $38.15 | 1346631843 - MIDWEST IMAGING CENTER II, LLC | 472889709 | MO | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $79.66 | 1396784641 - SHAWN REINHART | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 98981 | $39.65 | 1124118633 - MCALLEN ADVANCED MEDICAL IMAGING | 743023454 - (TX) MCALLEN ADVANCED MEDICAL IMAGING | TX | Radiology Clinic/Center (261QR0200X) |
United | 98981 | $64.02 | 1285669036 - ROBERT RUBINO | 521958352 - ATLANTIC HEALTH SYSTEM INC | NJ | Obstetrics & Gynecology Physician (207V00000X) |
United | 98981 | $46.25 | 1063426823 - MEMORIAL HEALTH SYSTEMS INC, FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER | 204281655 | FL | 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 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.
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