CPT code 98967: Telephone assessment, 11–20 minutes2026 Medicare rate & RVUs in Rhode Island

Reports 11–20 minutes of medical discussion by a qualified nonphysician health care professional with an established patient, parent, or guardian by telephone.

CMS RVU26DEffective Oct 1, 2026One payment locality9.6K Medicare services in 2024

In Rhode Island, Medicare pays $25.55 for 98967 in the office and $20.37 when it’s performed in a hospital or facility.

$25.55Office (non-facility)
$20.37Hospital or facility
+2.0%vs the national office rate ($25.05)

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.

We’ll open 98967 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Rhode Island
  2. What 98967 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

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 Rhode Island 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. Rhode Island pays $25.55. The RVUs are the same everywhere; the geographic indexes change the dollars.

98967 in Rhode Island vs other payment areas
  1. Rhode Island · this page$25.55
  2. Los Angeles, CA · California$26.92+$1.37
  3. Washington, DC area · District of Columbia$27.40+$1.85
  4. Miami, FL · Florida$26.39+$0.84
  5. Chicago, IL · Illinois$26.07+$0.52
  6. Manhattan, NY · New York$27.76+$2.21
  7. Alaska · Alaska$33.60+$8.05

Other areas in Rhode Island first, then benchmark localities. Bars start at $0.

Every other payment area

98967 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$23.80$19.42
ArkansasArkansas$23.64$19.34
ArizonaArizona$24.72$19.86
Bakersfield, CACalifornia$25.84$20.35
Chico, CACalifornia$25.76$20.27
El Centro, CACalifornia$25.77$20.27
Fresno, CACalifornia$25.76$20.27
Hanford, CACalifornia$25.76$20.27

98967 rates by state

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

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$23.64

$33.60

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
98967 office rate range by state
State / territoryOffice rate rangeLocalities
AK$33.601
AL$23.801
AR$23.641
AZ$24.721
CA$25.76–$29.9729
CO$25.601
CT$26.121
DC$27.401
DE$24.971
FL$25.05–$26.393
GA$24.35–$25.362
GU$25.821
HI$25.821
IA$23.991
ID$24.081
IL$24.76–$26.074
IN$24.151
KS$23.981
KY$24.141
LA$24.14–$24.692
MA$25.59–$27.152
MD$25.26–$27.403
ME$24.18–$24.742
MI$24.47–$25.242
MN$24.801
MO$23.97–$24.683
MS$23.811
MT$25.051
NC$24.291
ND$24.651
NE$24.041
NH$25.281
NJ$26.49–$27.382
NM$24.551
NV$24.951
NY$24.47–$28.145
OH$24.391
OK$24.081
OR$24.82–$26.002
PA$24.38–$25.802
PR$25.131
RI$25.551
SC$24.371
SD$24.611
TN$24.041
TX$24.31–$25.458
UT$24.521
VA$24.72–$27.402
VI$25.131
VT$24.641
WA$25.52–$27.512
WI$24.271
WV$24.331
WY$24.881

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.

How the rate is built · 98967

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.50

0.50 RVUs× 1.000 GPCI

Practice expense0.23

0.23 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

0.7500

Conversion factor

$33.4009

Medicare rate

$25.05

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Rhode Island inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,950

Code
98967
Physician work
0.50
Practice expense
0.23
Malpractice
0.02

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Office calculation for 98967 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work0.50× 1.0190.5095
Practice expense0.23× 1.0330.2376
Malpractice0.02× 0.8920.0178
Total RVUs0.7649
Conversion factor× 33.4009

Office rate, Rhode Island$25.55

Office: (0.5 × 1.019 + 0.23 × 1.033 + 0.02 × 0.892) × $33.4009 = $25.55

Facility: (0.5 × 1.019 + 0.08 × 1.033 + 0.02 × 0.892) × $33.4009 = $20.37

Open 98967 in the RVU calculator

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.

Place of service · 98967

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$25.05

Non-facility (office)
$25.05
Facility
$20.04

Higher because the practice carries its own overhead.

How 98967 has changed in Rhode Island

98967 · Office / nonfacility

$25.55

Effective 2026-10-01

The base rate is $1.03 higher than on 2025-10-01, moving from $24.52 to $25.55 (4.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $24.52changed to$25.55

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.22 changed to 0.23
    • Work GPCI 1.025 changed to 1.019
    • Practice expense GPCI 1.039 changed to 1.033
    • Malpractice GPCI 0.849 changed to 0.892

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $24.54changed to$24.52

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.20 changed to 0.22

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $24.14changed to$24.54

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $24.68changed to$24.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.19 changed to 0.20
    • Work GPCI 1.023 changed to 1.025
    • Practice expense GPCI 1.044 changed to 1.039
    • Malpractice GPCI 0.915 changed to 0.849
  5. January 1, 2023

    RVU23A

    $24.87changed to$24.68

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.18 changed to 0.19
    • Work GPCI 1.021 changed to 1.023
    • Practice expense GPCI 1.048 changed to 1.044
    • Malpractice GPCI 0.981 changed to 0.915

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $27.59changed to$24.87

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.23 changed to 0.18
    • Malpractice RVU 0.04 changed to 0.02

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $28.97changed to$27.59

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.024 changed to 1.021
    • Practice expense GPCI 1.049 changed to 1.048
    • Malpractice GPCI 0.990 changed to 0.981

    Held through RVU21B, RVU21C, RVU21D.

  8. April 1, 2020

    RVU20B

    No ratechanged to$28.97

    Held through RVU20C, RVU20D.

  9. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$25.55$20.37RVU26D
2026-07-01$25.55$20.37RVU26C
2026-04-01$25.55$20.37RVU26B
2026-01-01$25.55$20.37RVU26A
2025-10-01$24.52$22.50RVU25D
2025-07-01$24.52$22.50RVU25C
2025-04-01$24.52$22.50RVU25B
2025-01-01$24.52$22.50RVU25A
2024-10-01$24.54$22.47RVU24D
2024-07-01$24.54$22.47RVU24C
2024-04-01$24.54$22.47RVU24B
2024-03-09$24.54$22.47RVU24AR
2024-01-01$24.14$22.10RVU24A
2023-10-01$24.68$22.55RVU23D
2023-07-01$24.68$22.55RVU23C
2023-04-01$24.68$22.55RVU23B
2023-01-01$24.68$22.55RVU23A
2022-10-01$24.87$22.70RVU22D
2022-07-01$24.87$22.70RVU22C
2022-04-01$24.87$22.70RVU22B
2022-01-01$24.87$22.70RVU22A
2021-10-01$27.59$26.13RVU21D
2021-07-01$27.59$26.13RVU21C
2021-04-01$27.59$26.13RVU21B
2021-01-01$27.59$26.13RVU21A
2020-10-01$28.97$27.46RVU20D
2020-07-01$28.97$27.46RVU20C
2020-04-01$28.97$27.46RVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Separate payment rules applySeparate payment rules applyRVU19D
2019-07-01Separate payment rules applySeparate payment rules applyRVU19C
2019-04-01Separate payment rules applySeparate payment rules applyRVU19B
2019-01-01Separate payment rules applySeparate payment rules applyRVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price 98967 for an earlier date of service

Where the Rhode Island rate applies

Rhode Island is a Medicare payment area, not a city. Our Census mapping connects it to 36 cities and communities in Rhode Island. Some span more than one payment area; confirm with the service ZIP.

  • Ashaway
  • Bradford
  • Carolina
  • Central Falls
  • Charlestown
  • Chepachet
  • Clayville
  • Cranston

Browse all communities in Rhode Island

98967 billing questions

How much discussion time supports 98967?

Use 98967 for 11–20 minutes of medical discussion. Document the time and the clinical work performed during the call.

Can the call be reported with a related visit?

The CPT criteria exclude a call arising from a related assessment and management service within the preceding 7 days or leading to an assessment and management service or procedure within 24 hours or the soonest available appointment.

How does 98967 differ from 98971?

98967 describes a telephone medical discussion. 98971 is for an online digital assessment and management service, with time accumulated during a 7-day period.

What should the record include?

Document who participated, the patient’s clinical concern, the assessment or management provided, and the minutes of medical discussion.

Does the recipient need to be an established patient?

Yes. The service is for an established patient or the patient’s parent or guardian.

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

Show the CMS file lines behind this rate
RVUs for 98967PPRRVU2026_Oct_nonQPP.csv, line 12,950 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)

Open CMS sourceHow we calculate rates

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