How much does Medicare pay for CPT 98980?

Medicare allowed an average of $49.72 per service and paid $39.11 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $142.34, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 98980 pay differently in an office than a hospital?

Yes. The allowed amount averaged $49.76 in an office setting and $28.81 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 98980 most?

Physical Therapist in Private Practice, with 41,785 services from 573 clinicians. Next are Emergency Medicine, Pulmonary Disease, Family Practice.

CPT 98980

Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month

$49.72Medicare-allowed amount per service, averaged across 105,643 services

Providers submitted

$142.34

Asking price, not received

Medicare allowed

$49.72

The fee schedule figure

Medicare paid

$39.11

Balance is patient coinsurance

Providers submitted an average of $142.34 for this code and Medicare allowed $49.72 — 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 $39.11 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $49.76
Hospital / facility: $28.81

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. 105,439 services were billed in an office setting and 204 in a facility.

Services: 105,643
Beneficiaries: 43,650
Providers billing it: 906
Total allowed: $5,252,570

What Medicare pays for CPT 98980

Across 105,643 services billed by 906 providers to 43,650 beneficiaries, Medicare allowed an average of $49.72 per service. That is 2.4 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 98980

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	41,785	23,546	$48.66	573
Emergency Medicine	11,189	2,656	$53.95	9
Pulmonary Disease	6,771	1,526	$47.02	14
Family Practice	5,493	2,292	$49.61	16
Pain Management	5,287	1,515	$50.12	40
Physician Assistant	4,708	2,546	$44.30	38
Physical Medicine and Rehabilitation	4,663	1,287	$52.68	28
Anesthesiology	4,611	1,208	$52.17	25
Internal Medicine	3,536	1,112	$54.07	14
Nurse Practitioner	3,456	1,198	$42.08	41
Orthopedic Surgery	2,878	1,353	$50.46	32
Interventional Pain Management	2,580	829	$51.98	23
General Practice	2,419	360	$51.63	4
Obstetrics & Gynecology	961	189	$54.69	1
Nephrology	941	158	$52.30	2

98980 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	16,896	$54.01	$39.03	97
New Jersey	7,796	$53.09	$38.40	74
Texas	7,374	$47.92	$37.95	75
Arizona	7,241	$47.46	$38.34	55
Florida	6,135	$48.76	$38.43	61
Georgia	5,830	$48.10	$39.31	12
New York	5,514	$57.00	$39.33	27
Utah	4,691	$46.91	$38.99	2
Illinois	3,809	$49.47	$37.82	49
Delaware	3,670	$46.80	$37.34	33
Oklahoma	3,232	$45.86	$38.90	6
Pennsylvania	2,992	$47.78	$37.06	48
Nevada	2,775	$52.20	$39.02	21
Washington	2,579	$49.70	$36.71	42
Connecticut	2,434	$52.40	$39.32	15
Oregon	2,388	$51.38	$38.24	12
Virginia	2,229	$47.77	$36.01	40
South Carolina	1,934	$46.42	$38.06	19
Michigan	1,775	$45.13	$34.46	7
Wisconsin	1,665	$45.85	$37.90	19
Maryland	1,643	$47.06	$34.88	27
Kansas	1,586	$43.77	$36.31	9
North Carolina	1,314	$48.62	$39.46	17
District of Columbia	1,269	$47.87	$33.60	1
Tennessee	1,232	$42.47	$35.15	25
Missouri	817	$44.68	$36.08	12
Colorado	776	$51.00	$39.50	8
Ohio	699	$46.24	$37.36	10
Alaska	484	$57.52	$35.90	5
Indiana	365	$43.17	$35.47	6
Massachusetts	338	$50.40	$36.80	11
Louisiana	323	$45.69	$37.91	4
Iowa	319	$42.51	$34.15	11
New Mexico	258	$42.31	$34.66	8
Kentucky	213	$44.12	$38.16	6
Nebraska	178	$42.13	$35.17	6
Alabama	150	$42.79	$37.18	6
Hawaii	145	$46.97	$36.59	3
Arkansas	144	$45.16	$39.49	5
Idaho	130	$46.04	$38.07	3
Mississippi	85	$40.26	$33.72	4
Puerto Rico	65	$46.47	$39.67	1
Minnesota	55	$49.42	$39.55	1
Rhode Island	43	$44.87	$33.56	1
New Hampshire	27	$56.55	$38.52	1
Maine	26	$26.32	$19.36	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
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
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.