CPT code 98960: Self-management training, individual, per 30 minutes2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 98960 covers

This service covers individualized, face-to-face education that helps a patient develop skills to manage a health condition. A qualified nonphysician health care professional uses a standardized curriculum; a nurse, dietitian, or pharmacist may provide the training when qualified. The patient is trained individually, though a caregiver or family member may participate. Examples include instruction on managing a chronic condition, following a care plan, or using self-management techniques in daily life.

CPT 98960 represents each 30 minutes of this individual training. Medicare assigns it physician fee schedule status B, meaning Medicare never pays it separately; its payment is included in payment for other services. The code is distinct from the related group-training codes, which are selected according to the number of patients trained together. Document the patient’s participation, training content, curriculum, and time spent so the individual service and its units are clear.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 98960 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

98960 rates by state

Office rate range in each state. Select a state to see its payment localities.

How the 98960 rate is calculated

Each of 98960’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 98960

98960 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

98960 compared with similar codes

How to choose

98961Self-management education2-4 patients

98960 is for one patient; 98961 is for self-management training delivered to a group of 2–4 patients.

98962Self-management trainingGroup of 5-8

98960 is for one patient; 98962 applies when the training group has 5–8 patients.

G0108Diabetes trainingIndividual, per 30 minutes

G0108 identifies individual diabetes self-management training; 98960 describes individualized self-management training more generally.

98970Digital assessmentQualified nonphysician, 5–10 minutes

98970 describes online digital assessment and management by a qualified professional, not face-to-face education using a standardized self-management curriculum.

Codes related to 98960

Related codes aren’t interchangeable: bill the code that matches the service performed.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates