CPT code 98962: Self-management training, group of 5-82026 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 98962 covers

This code describes face-to-face instruction that develops patients’ ability to manage a health condition, using a standardized curriculum. A qualified nonphysician health care professional leads the session for a group of 5-8 patients. The group-size distinction separates 98962 from individual training and the smaller-group service in the same series. It represents structured patient education rather than a telephone assessment or online digital management service.

Each unit represents 30 minutes of training. Medicare assigns this code physician fee schedule status B: Medicare never pays it separately, and its payment is included in payment for other services. The group count and training duration identify the service represented; records should support the training provided, its duration, the professional furnishing it, and the number of patients attending.

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 98962 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

98962 rates by state

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

How the 98962 rate is calculated

Each of 98962’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 98962

98962 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.

98962 compared with similar codes

How to choose

98960Self-management trainingIndividual, per 30 minutes

98960 is for individual self-management training; 98962 is for groups of 5-8 patients.

98961Self-management education2-4 patients

98961 applies to groups of 2-4 patients. Select 98962 when the group has 5-8.

98966Telephone assessment5–10 minutes

98966 describes a nonphysician professional's telephone assessment and management service, not face-to-face group self-management training.

99078Group educationHealth education

99078 describes attendance at group health education sessions; 98962 is for structured self-management training for groups of 5-8.

Codes related to 98962

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