CPT code 98967: Telephone assessment, 11–20 minutes2026 Medicare rate & RVUs in Washington, DC area

In Washington, DC area, Medicare pays $27.40 for 98967 in the office and $21.49 when it’s performed in a hospital or facility.

Check a contract rate as a % of Medicare · 98967 nationwide

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

What 98967 covers

This service covers a telephone medical discussion between a qualified nonphysician health care professional and an established patient, parent, or guardian. An NP or PA may use it to assess a change in symptoms, discuss a medication response, or address another clinical concern that can be managed by phone. It is a discussion service, not an online exchange or patient self-management education session.

Select 98967 when the medical discussion lasts 11–20 minutes; use the adjacent telephone codes for shorter or longer discussions. Document the recipient, clinical issue, assessment or management provided, and time spent in medical discussion. The CPT reporting criteria exclude a call that arises from a related assessment and management service in the prior 7 days or leads to an assessment and management service or procedure within 24 hours or the soonest available appointment. CMS assigns work, practice-expense, and malpractice RVUs, with separate office and facility practice-expense inputs.

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.

How Washington, DC area compares for 98967

Across 109 of 109 payment localities, the office rate for 98967 runs from $23.64 in Arkansas to $33.60 in Alaska. Washington, DC area pays $27.40. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

98967 rates by state

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

See 98967 in every payment locality

How the 98967 rate is calculated

Each of 98967’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 98967

98967 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.

Codes related to 98967

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

How 98967 has changed in Washington, DC area

Price 98967 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

Browse all communities in District of Columbia

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