How much does Medicare pay for CPT 98981?

Medicare allowed an average of $38.72 per service and paid $30.56 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $126.52, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

Does 98981 pay differently in an office than a hospital?

Yes. The allowed amount averaged $38.73 in an office setting and $31.76 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 98981 most?

Physical Therapist in Private Practice, with 31,029 services from 208 clinicians. Next are Emergency Medicine, Pain Management, Physician Assistant.

CPT 98981

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

$38.72Medicare-allowed amount per service, averaged across 64,061 services

Providers submitted

$126.52

Asking price, not received

Medicare allowed

$38.72

The fee schedule figure

Medicare paid

$30.56

Balance is patient coinsurance

Providers submitted an average of $126.52 for this code and Medicare allowed $38.72 — 3.3× 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 $30.56 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $38.73
Hospital / facility: $31.76

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. 64,032 services were billed in an office setting and 29 in a facility.

Services: 64,061
Beneficiaries: 21,539
Providers billing it: 417
Total allowed: $2,480,442

What Medicare pays for CPT 98981

Across 64,061 services billed by 417 providers to 21,539 beneficiaries, Medicare allowed an average of $38.72 per service. That is 3.0 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 98981

Specialty	Services	Beneficiaries	Avg allowed	Providers
Physical Therapist in Private Practice	31,029	11,466	$38.03	208
Emergency Medicine	5,328	1,762	$42.60	9
Pain Management	4,578	988	$39.03	27
Physician Assistant	3,263	809	$34.09	27
Anesthesiology	3,139	760	$39.72	21
Orthopedic Surgery	2,617	834	$40.19	21
Nurse Practitioner	2,558	660	$33.90	19
Physical Medicine and Rehabilitation	1,919	595	$40.55	17
Interventional Pain Management	1,726	453	$39.78	14
Pulmonary Disease	1,602	699	$37.71	8
Internal Medicine	1,452	621	$42.41	10
General Practice	941	296	$40.20	3
Family Practice	911	508	$42.16	11
Nephrology	834	153	$41.92	2
Pediatric Medicine	415	181	$38.84	1

98981 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
Utah	9,294	$37.86	$30.99	1
California	6,363	$42.65	$30.82	41
New Jersey	4,490	$41.12	$30.02	46
Texas	4,443	$38.08	$30.13	38
Delaware	3,759	$36.69	$29.56	22
New York	3,640	$44.43	$31.19	17
Florida	3,628	$39.60	$30.80	31
Arizona	3,504	$38.14	$30.80	29
Illinois	2,692	$39.62	$30.40	22
Kansas	2,670	$33.16	$27.40	6
Michigan	2,458	$36.04	$26.76	5
Georgia	2,111	$38.65	$31.09	8
Pennsylvania	1,921	$36.94	$29.05	20
Wisconsin	1,750	$36.66	$30.39	10
Maryland	1,604	$35.86	$26.92	13
Virginia	1,545	$38.24	$28.35	14
Nevada	973	$40.36	$30.88	8
Oklahoma	839	$38.31	$31.15	2
Washington	836	$34.84	$27.18	7
Colorado	668	$40.16	$31.29	4
South Carolina	628	$36.19	$29.52	8
Tennessee	627	$35.62	$29.11	12
Oregon	551	$39.59	$31.46	4
Alaska	447	$47.91	$29.88	4
Ohio	410	$36.64	$29.78	4
New Mexico	296	$33.66	$27.15	5
Connecticut	296	$41.77	$31.30	2
Iowa	283	$34.78	$27.91	6
North Carolina	234	$40.97	$31.30	6
Louisiana	178	$36.00	$30.24	4
Missouri	158	$33.16	$26.62	2
Hawaii	141	$24.61	$27.55	2
Indiana	127	$34.07	$27.99	1
Arkansas	107	$36.12	$31.19	3
Minnesota	82	$38.70	$31.21	1
Kentucky	68	$33.79	$26.78	1
Rhode Island	65	$35.33	$26.49	1
Idaho	49	$36.88	$29.48	2
Mississippi	45	$32.77	$26.62	2
Nebraska	33	$31.57	$25.88	1
Massachusetts	25	$39.02	$29.88	1
Alabama	23	$37.07	$30.70	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
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.