How much does Medicare pay for CPT 98925?

Medicare allowed an average of $30.48 per service and paid $23.00 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $93.55, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 98925?

Osteopathic manipulative treatment, 1-2 body regions. It was billed 31,913 times to 12,085 Medicare beneficiaries by 388 providers in 2024.

Does 98925 pay differently in an office than a hospital?

Yes. The allowed amount averaged $30.92 in an office setting and $25.06 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 98925 most?

Family Practice, with 11,482 services from 181 clinicians. Next are Physical Medicine and Rehabilitation, Nurse Practitioner, Osteopathic Manipulative Medicine.

CPT 98925

Osteopathic manipulative treatment, 1-2 body regions

$30.48Medicare-allowed amount per service, averaged across 31,913 services

Providers submitted

$93.55

Asking price, not received

Medicare allowed

$30.48

The fee schedule figure

Medicare paid

$23.00

Balance is patient coinsurance

Providers submitted an average of $93.55 for this code and Medicare allowed $30.48 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $23.00 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $30.92
Hospital / facility: $25.06

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 29,558 services were billed in an office setting and 2,355 in a facility.

Services: 31,913
Beneficiaries: 12,085
Providers billing it: 388
Total allowed: $972,708

What Medicare pays for CPT 98925

Across 31,913 services billed by 388 providers to 12,085 beneficiaries, Medicare allowed an average of $30.48 per service. That is 2.6 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 98925

Specialty	Services	Beneficiaries	Avg allowed	Providers
Family Practice	11,482	4,954	$30.14	181
Physical Medicine and Rehabilitation	4,524	1,804	$31.34	50
Nurse Practitioner	4,312	816	$28.11	23
Osteopathic Manipulative Medicine	3,371	1,343	$31.90	45
Internal Medicine	1,926	911	$31.58	35
Physical Therapist in Private Practice	1,550	382	$30.89	6
General Practice	1,046	419	$32.08	12
Orthopedic Surgery	981	413	$29.79	4
Sports Medicine	695	253	$30.95	6
Pain Management	559	152	$30.09	2
Physician Assistant	386	70	$30.22	1
Obstetrics & Gynecology	338	134	$31.70	1
Interventional Pain Management	209	130	$30.45	5
Anesthesiology	146	37	$32.65	3
Podiatry	116	55	$38.45	2

98925 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	6,948	$31.61	$22.04	35
California	3,879	$33.01	$22.75	38
Indiana	2,885	$28.99	$23.60	12
Arizona	1,934	$30.65	$23.36	15
Florida	1,884	$28.24	$21.36	29
New Jersey	1,726	$32.47	$23.69	16
Texas	1,676	$28.94	$21.83	29
Alaska	1,229	$32.87	$18.47	15
Virginia	1,000	$30.75	$23.21	14
Michigan	867	$28.63	$21.37	23
Pennsylvania	795	$28.08	$21.44	15
Missouri	791	$28.38	$21.50	18
Illinois	688	$31.08	$22.47	13
Nevada	608	$30.00	$23.73	2
Ohio	548	$27.62	$20.20	20
Colorado	542	$30.47	$22.18	6
Washington	472	$33.20	$23.11	10
Wisconsin	310	$27.85	$21.30	10
Massachusetts	307	$30.17	$22.10	6
Arkansas	294	$23.98	$19.93	1
Connecticut	250	$31.93	$23.09	5
Idaho	240	$28.57	$23.36	2
Oregon	236	$28.98	$19.82	6
Tennessee	207	$25.02	$21.00	2
Hawaii	148	$31.16	$22.82	3
Maine	146	$26.07	$20.01	3
Iowa	133	$23.86	$18.04	5
Montana	126	$30.76	$22.00	2
Maryland	118	$27.19	$19.51	2
Kansas	110	$21.26	$15.70	3
Oklahoma	109	$26.94	$19.63	6
Minnesota	88	$30.92	$22.90	3
District of Columbia	86	$34.58	$22.79	1
New Mexico	86	$29.54	$22.66	2
Nebraska	74	$29.71	$21.41	2
Puerto Rico	67	$30.54	$19.75	1
Utah	55	$29.76	$23.61	1
Georgia	53	$27.03	$18.63	3
South Dakota	43	$21.68	$13.74	1
Vermont	40	$30.16	$23.10	1
North Carolina	37	$29.00	$23.24	2
New Hampshire	32	$31.56	$22.17	2
Kentucky	18	$29.47	$23.23	1
West Virginia	15	$21.99	$13.13	1
Wyoming	13	$30.62	$24.47	1

Related codes

98941Chiropractic manipulative treatment$38.12
98940Chiropractic manipulative treatment$26.75
98942Chiropractic manipulative treatment$49.84
98977Device supply$48.07
98976Device supply$48.79
98980Remote therapeutic monitoring treatment management services by physici$49.72
98929Osteopathic manipulative treatment$83.31
98928Osteopathic manipulative treatment$70.48
98926Osteopathic manipulative treatment$43.00
98927Osteopathic manipulative treatment$57.47
98981Remote therapeutic monitoring treatment management services by physici$38.72
98975Set-up and patient education for remote monitoring of therapy$20.19

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.