How much does Medicare pay for CPT 98975?

Medicare allowed an average of $20.19 per service and paid $15.86 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $59.52, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 98975?

Set-up and patient education for remote monitoring of therapy. It was billed 43,989 times to 41,656 Medicare beneficiaries by 948 providers in 2024.

Does 98975 pay differently in an office than a hospital?

Yes. The allowed amount averaged $20.19 in an office setting and $16.80 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 98975 most?

Physical Therapist in Private Practice, with 24,298 services from 619 clinicians. Next are Family Practice, Emergency Medicine, Orthopedic Surgery.

CPT 98975

Set-up and patient education for remote monitoring of therapy

$20.19Medicare-allowed amount per service, averaged across 43,989 services

Providers submitted

$59.52

Asking price, not received

Medicare allowed

$20.19

The fee schedule figure

Medicare paid

$15.86

Balance is patient coinsurance

Providers submitted an average of $59.52 for this code and Medicare allowed $20.19 — 2.9× 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 $15.86 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $20.19
Hospital / facility: $16.80

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. 43,939 services were billed in an office setting and 50 in a facility.

Services: 43,989
Beneficiaries: 41,656
Providers billing it: 948
Total allowed: $888,138

What Medicare pays for CPT 98975

Across 43,989 services billed by 948 providers to 41,656 beneficiaries, Medicare allowed an average of $20.19 per service. 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 98975

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	24,298	22,439	$20.05	619
Family Practice	3,456	3,429	$21.12	15
Emergency Medicine	3,139	3,073	$21.54	12
Orthopedic Surgery	2,602	2,553	$19.53	78
Physician Assistant	1,831	1,761	$18.94	24
Internal Medicine	1,233	1,213	$21.28	9
Pulmonary Disease	1,030	1,022	$18.30	17
Anesthesiology	984	945	$21.18	26
Pain Management	912	895	$20.65	30
Physical Medicine and Rehabilitation	868	821	$20.39	21
Neurology	718	710	$22.72	5
Nurse Practitioner	703	701	$16.36	31
Interventional Pain Management	457	450	$21.12	14
Occupational Therapist in Private Practice	351	342	$20.41	15
Rheumatology	321	318	$21.55	9

98975 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
California	8,144	$23.34	$15.39	125
Florida	2,924	$18.55	$14.99	79
New Jersey	2,911	$22.04	$15.26	59
Kansas	2,858	$17.02	$14.43	11
Arizona	2,802	$18.81	$15.00	73
Texas	2,634	$18.96	$15.07	66
New York	1,757	$22.58	$15.43	40
Washington	1,566	$20.92	$15.24	31
Connecticut	1,533	$20.74	$15.61	15
Michigan	1,440	$19.96	$15.29	14
Nevada	1,328	$21.64	$15.49	10
North Carolina	1,327	$18.35	$15.14	41
District of Columbia	1,303	$19.88	$13.31	2
Georgia	1,280	$18.95	$15.31	27
Illinois	983	$19.77	$15.19	29
Pennsylvania	867	$19.16	$15.09	35
Oregon	856	$19.18	$15.36	26
Virginia	836	$19.41	$15.41	21
Massachusetts	709	$21.74	$14.84	30
Colorado	683	$20.43	$15.52	21
South Carolina	578	$17.93	$15.37	21
Maryland	560	$19.80	$14.66	20
Oklahoma	489	$17.28	$14.87	11
Tennessee	487	$16.85	$15.03	19
Wisconsin	446	$17.42	$14.68	15
Missouri	275	$17.07	$14.51	11
Louisiana	268	$17.47	$15.45	6
Delaware	233	$19.35	$14.55	14
Ohio	230	$18.63	$14.18	5
Indiana	192	$16.52	$14.32	3
Nebraska	191	$16.99	$15.55	6
Alabama	185	$15.44	$14.75	9
Kentucky	154	$16.85	$15.26	8
Arkansas	143	$16.05	$14.08	4
Iowa	137	$18.25	$14.71	8
Minnesota	134	$19.97	$14.90	9
Alaska	113	$20.49	$15.18	3
Hawaii	108	$21.23	$15.64	4
Idaho	95	$17.46	$15.27	4
New Hampshire	84	$20.68	$15.15	5
New Mexico	74	$17.02	$14.31	4
Mississippi	26	$16.72	$15.65	1
West Virginia	18	$17.17	$15.58	1
Wyoming	15	$20.12	$15.50	1
Rhode Island	13	$20.29	$15.66	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
98925Osteopathic manipulative treatment$30.48

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.