CPT code 98967: Telephone assessment, 11–20 minutes2026 Medicare rate & RVUs in South Carolina
Reports 11–20 minutes of medical discussion by a qualified nonphysician health care professional with an established patient, parent, or guardian by telephone.
In South Carolina, Medicare pays $24.37 for 98967 in the office and $19.74 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.
On this page 11 sections
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 South Carolina 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. South Carolina pays $24.37. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Carolina · this page$24.37
- Los Angeles, CA · California$26.92+$2.55
- Washington, DC area · District of Columbia$27.40+$3.03
- Miami, FL · Florida$26.39+$2.02
- Chicago, IL · Illinois$26.07+$1.70
- Manhattan, NY · New York$27.76+$3.39
- Alaska · Alaska$33.60+$9.23
Other areas in South Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| 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 |
| Madera, CACalifornia | $25.76 | $20.27 |
| Merced, CACalifornia | $25.76 | $20.27 |
| Modesto, CACalifornia | $25.76 | $20.27 |
| Napa, CACalifornia | $28.22 | $21.61 |
| Oxnard, CACalifornia | $26.66 | $20.74 |
| Redding, CACalifornia | $25.76 | $20.27 |
| Rest of CaliforniaCalifornia | $25.76 | $20.27 |
| Riverside, CACalifornia | $25.99 | $20.50 |
| Sacramento, CACalifornia | $26.59 | $20.77 |
| Salinas, CACalifornia | $26.48 | $20.67 |
| San Diego, CACalifornia | $26.75 | $20.76 |
| Marin County, CACalifornia | $29.43 | $22.36 |
| San Francisco, CACalifornia | $29.40 | $22.34 |
| San Benito County, CACalifornia | $29.97 | $22.75 |
| Santa Clara County, CACalifornia | $29.88 | $22.66 |
| San Luis Obispo, CACalifornia | $26.09 | $20.39 |
| Santa Cruz, CACalifornia | $26.74 | $20.66 |
| Santa Maria, CACalifornia | $26.48 | $20.64 |
| Santa Rosa, CACalifornia | $26.99 | $20.84 |
| Stockton, CACalifornia | $25.76 | $20.27 |
| Vallejo, CACalifornia | $28.18 | $21.58 |
| Visalia, CACalifornia | $25.76 | $20.27 |
| Yuba City, CACalifornia | $25.76 | $20.27 |
| ColoradoColorado | $25.60 | $20.27 |
| ConnecticutConnecticut | $26.12 | $20.72 |
| DelawareDelaware | $24.97 | $20.02 |
| Fort Lauderdale, FLFlorida | $25.69 | $20.62 |
| Rest of FloridaFlorida | $25.05 | $20.26 |
| Atlanta, GAGeorgia | $25.36 | $20.27 |
| Rest of GeorgiaGeorgia | $24.35 | $19.88 |
| Hawaii, Guam, HIHawaii | $25.82 | $20.13 |
| IowaIowa | $23.99 | $19.41 |
| IdahoIdaho | $24.08 | $19.47 |
| East St. Louis, ILIllinois | $25.11 | $20.50 |
| Rest of IllinoisIllinois | $24.76 | $20.18 |
| Suburban Chicago, ILIllinois | $25.89 | $20.75 |
| IndianaIndiana | $24.15 | $19.50 |
| KansasKansas | $23.98 | $19.45 |
| KentuckyKentucky | $24.14 | $19.69 |
| New Orleans, LALouisiana | $24.69 | $19.97 |
| Rest of LouisianaLouisiana | $24.14 | $19.71 |
| Metropolitan Boston, MAMassachusetts | $27.15 | $21.17 |
| Rest of MassachusettsMassachusetts | $25.59 | $20.31 |
| Baltimore area, MDMaryland | $26.04 | $20.66 |
| Rest of MarylandMaryland | $25.26 | $20.18 |
| Rest of MaineMaine | $24.18 | $19.57 |
| Southern Maine, MEMaine | $24.74 | $19.77 |
| Detroit, MIMichigan | $25.24 | $20.41 |
| Rest of MichiganMichigan | $24.47 | $19.89 |
| MinnesotaMinnesota | $24.80 | $19.65 |
| Metropolitan Kansas City, MOMissouri | $24.57 | $19.86 |
| Metropolitan St. Louis, MOMissouri | $24.68 | $19.91 |
| Rest of MissouriMissouri | $23.97 | $19.65 |
| MississippiMississippi | $23.81 | $19.49 |
| MontanaMontana | $25.05 | $20.04 |
| North CarolinaNorth Carolina | $24.29 | $19.62 |
| North DakotaNorth Dakota | $24.65 | $19.64 |
| NebraskaNebraska | $24.04 | $19.42 |
| New HampshireNew Hampshire | $25.28 | $20.07 |
| Northern New JerseyNew Jersey | $27.38 | $21.57 |
| Rest of New JerseyNew Jersey | $26.49 | $21.02 |
| New MexicoNew Mexico | $24.55 | $19.95 |
| NevadaNevada | $24.95 | $19.93 |
| NYC suburbs and Long Island, NYNew York | $28.14 | $22.19 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $26.67 | $21.19 |
| Queens, NYNew York | $27.81 | $21.89 |
| Rest of New YorkNew York | $24.47 | $19.71 |
| OhioOhio | $24.39 | $19.81 |
| OklahomaOklahoma | $24.08 | $19.61 |
| Portland, OROregon | $26.00 | $20.43 |
| Rest of OregonOregon | $24.82 | $19.83 |
| Metropolitan Philadelphia, PAPennsylvania | $25.80 | $20.58 |
| Rest of PennsylvaniaPennsylvania | $24.38 | $19.78 |
| Puerto RicoPuerto Rico | $25.13 | $20.06 |
| Rhode IslandRhode Island | $25.55 | $20.37 |
| South DakotaSouth Dakota | $24.61 | $19.60 |
| TennesseeTennessee | $24.04 | $19.49 |
| Austin, TXTexas | $25.45 | $20.15 |
| Beaumont, TXTexas | $24.31 | $19.75 |
| Brazoria, TXTexas | $24.97 | $20.00 |
| Dallas, TXTexas | $25.08 | $20.09 |
| Fort Worth, TXTexas | $25.01 | $20.07 |
| Galveston, TXTexas | $25.02 | $20.04 |
| Houston, TXTexas | $25.38 | $20.41 |
| Rest of TexasTexas | $24.59 | $19.84 |
| UtahUtah | $24.52 | $19.81 |
| VirginiaVirginia | $24.72 | $19.80 |
| Virgin Islands, VIUnited States Virgin Islands | $25.13 | $20.06 |
| VermontVermont | $24.64 | $19.68 |
| Rest of WashingtonWashington | $25.52 | $20.24 |
| King County, WAWashington | $27.51 | $21.36 |
| WisconsinWisconsin | $24.27 | $19.47 |
| West VirginiaWest Virginia | $24.33 | $19.98 |
| WyomingWyoming | $24.88 | $19.87 |
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $33.60 | 1 |
| AL | $23.80 | 1 |
| AR | $23.64 | 1 |
| AZ | $24.72 | 1 |
| CA | $25.76–$29.97 | 29 |
| CO | $25.60 | 1 |
| CT | $26.12 | 1 |
| DC | $27.40 | 1 |
| DE | $24.97 | 1 |
| FL | $25.05–$26.39 | 3 |
| GA | $24.35–$25.36 | 2 |
| GU | $25.82 | 1 |
| HI | $25.82 | 1 |
| IA | $23.99 | 1 |
| ID | $24.08 | 1 |
| IL | $24.76–$26.07 | 4 |
| IN | $24.15 | 1 |
| KS | $23.98 | 1 |
| KY | $24.14 | 1 |
| LA | $24.14–$24.69 | 2 |
| MA | $25.59–$27.15 | 2 |
| MD | $25.26–$27.40 | 3 |
| ME | $24.18–$24.74 | 2 |
| MI | $24.47–$25.24 | 2 |
| MN | $24.80 | 1 |
| MO | $23.97–$24.68 | 3 |
| MS | $23.81 | 1 |
| MT | $25.05 | 1 |
| NC | $24.29 | 1 |
| ND | $24.65 | 1 |
| NE | $24.04 | 1 |
| NH | $25.28 | 1 |
| NJ | $26.49–$27.38 | 2 |
| NM | $24.55 | 1 |
| NV | $24.95 | 1 |
| NY | $24.47–$28.14 | 5 |
| OH | $24.39 | 1 |
| OK | $24.08 | 1 |
| OR | $24.82–$26.00 | 2 |
| PA | $24.38–$25.80 | 2 |
| PR | $25.13 | 1 |
| RI | $25.55 | 1 |
| SC | $24.37 | 1 |
| SD | $24.61 | 1 |
| TN | $24.04 | 1 |
| TX | $24.31–$25.45 | 8 |
| UT | $24.52 | 1 |
| VA | $24.72–$27.40 | 2 |
| VI | $25.13 | 1 |
| VT | $24.64 | 1 |
| WA | $25.52–$27.51 | 2 |
| WI | $24.27 | 1 |
| WV | $24.33 | 1 |
| WY | $24.88 | 1 |
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
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 South Carolina 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
93
- Locality
- South Carolina
- Physician work
- 1.000
- Practice expense
- 0.924
- Malpractice
- 0.850
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.50 | × 1.000 | 0.5000 |
| Practice expense | 0.23 | × 0.924 | 0.2125 |
| Malpractice | 0.02 | × 0.850 | 0.0170 |
| Total RVUs | 0.7295 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Carolina$24.37
Office: (0.5 × 1 + 0.23 × 0.924 + 0.02 × 0.85) × $33.4009 = $24.37
Facility: (0.5 × 1 + 0.08 × 0.924 + 0.02 × 0.85) × $33.4009 = $19.74
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 South Carolina
98967 · Office / nonfacility
$24.37
Effective 2026-10-01
The base rate is $1.17 higher than on 2025-10-01, moving from $23.20 to $24.37 (5.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$23.20changed to$24.37
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.22 changed to 0.23
- Practice expense GPCI 0.913 changed to 0.924
- Malpractice GPCI 0.817 changed to 0.850
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$23.27changed to$23.20
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.20 changed to 0.22
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$22.89changed to$23.27
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$23.30changed to$22.89
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.19 changed to 0.20
- Practice expense GPCI 0.908 changed to 0.913
- Malpractice GPCI 0.756 changed to 0.817
January 1, 2023
RVU23A
$23.41changed to$23.30
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.18 changed to 0.19
- Practice expense GPCI 0.903 changed to 0.908
- Malpractice GPCI 0.695 changed to 0.756
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$25.66changed to$23.41
- 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.
January 1, 2021
RVU21A
$26.70changed to$25.66
- Conversion factor 36.0896 changed to 34.8931
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.907 changed to 0.903
- Malpractice GPCI 0.624 changed to 0.695
Held through RVU21B, RVU21C, RVU21D.
April 1, 2020
RVU20B
No ratechanged to$26.70
Held through RVU20C, RVU20D.
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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $24.37 | $19.74 | RVU26D |
| 2026-07-01 | $24.37 | $19.74 | RVU26C |
| 2026-04-01 | $24.37 | $19.74 | RVU26B |
| 2026-01-01 | $24.37 | $19.74 | RVU26A |
| 2025-10-01 | $23.20 | $21.43 | RVU25D |
| 2025-07-01 | $23.20 | $21.43 | RVU25C |
| 2025-04-01 | $23.20 | $21.43 | RVU25B |
| 2025-01-01 | $23.20 | $21.43 | RVU25A |
| 2024-10-01 | $23.27 | $21.44 | RVU24D |
| 2024-07-01 | $23.27 | $21.44 | RVU24C |
| 2024-04-01 | $23.27 | $21.44 | RVU24B |
| 2024-03-09 | $23.27 | $21.44 | RVU24AR |
| 2024-01-01 | $22.89 | $21.09 | RVU24A |
| 2023-10-01 | $23.30 | $21.46 | RVU23D |
| 2023-07-01 | $23.30 | $21.46 | RVU23C |
| 2023-04-01 | $23.30 | $21.46 | RVU23B |
| 2023-01-01 | $23.30 | $21.46 | RVU23A |
| 2022-10-01 | $23.41 | $21.53 | RVU22D |
| 2022-07-01 | $23.41 | $21.53 | RVU22C |
| 2022-04-01 | $23.41 | $21.53 | RVU22B |
| 2022-01-01 | $23.41 | $21.53 | RVU22A |
| 2021-10-01 | $25.66 | $24.40 | RVU21D |
| 2021-07-01 | $25.66 | $24.40 | RVU21C |
| 2021-04-01 | $25.66 | $24.40 | RVU21B |
| 2021-01-01 | $25.66 | $24.40 | RVU21A |
| 2020-10-01 | $26.70 | $25.39 | RVU20D |
| 2020-07-01 | $26.70 | $25.39 | RVU20C |
| 2020-04-01 | $26.70 | $25.39 | RVU20B |
| 2020-01-01 | Separate payment rules apply | Separate payment rules apply | RVU20A |
| 2019-10-01 | Separate payment rules apply | Separate payment rules apply | RVU19D |
| 2019-07-01 | Separate payment rules apply | Separate payment rules apply | RVU19C |
| 2019-04-01 | Separate payment rules apply | Separate payment rules apply | RVU19B |
| 2019-01-01 | Separate payment rules apply | Separate payment rules apply | RVU19A |
| 2018-10-01 | Separate payment rules apply | Separate payment rules apply | RVU18D |
| 2018-07-01 | Separate payment rules apply | Separate payment rules apply | RVU18C |
| 2018-04-01 | Separate payment rules apply | Separate payment rules apply | RVU18B |
| 2018-01-01 | Separate payment rules apply | Separate payment rules apply | RVU18AR1 |
| 2017-10-01 | Separate payment rules apply | Separate payment rules apply | RVU17D |
| 2017-07-01 | Separate payment rules apply | Separate payment rules apply | RVU17C |
| 2017-04-01 | Separate payment rules apply | Separate payment rules apply | RVU17B |
| 2017-01-01 | Separate payment rules apply | Separate payment rules apply | RVU17A |
| 2016-10-01 | Separate payment rules apply | Separate payment rules apply | RVU16D |
| 2016-07-01 | Separate payment rules apply | Separate payment rules apply | RVU16C |
| 2016-04-01 | Separate payment rules apply | Separate payment rules apply | RVU16B |
| 2016-01-01 | Separate payment rules apply | Separate payment rules apply | RVU16A |
| 2015-10-01 | Separate payment rules apply | Separate payment rules apply | RVU15D |
| 2015-07-01 | Separate payment rules apply | Separate payment rules apply | RVU15C |
| 2015-04-01 | Separate payment rules apply | Separate payment rules apply | RVU15B |
| 2015-01-01 | Separate payment rules apply | Separate payment rules apply | RVU15A |
| 2014-10-01 | Separate payment rules apply | Separate payment rules apply | RVU14D |
| 2014-07-01 | Separate payment rules apply | Separate payment rules apply | RVU14C |
| 2014-04-01 | Separate payment rules apply | Separate payment rules apply | RVU14B |
| 2014-01-01 | Separate payment rules apply | Separate payment rules apply | RVU14A |
| 2013-10-01 | Separate payment rules apply | Separate payment rules apply | RVU13D |
| 2013-07-01 | Separate payment rules apply | Separate payment rules apply | RVU13C |
| 2013-04-01 | Separate payment rules apply | Separate payment rules apply | RVU13B |
| 2013-01-01 | Separate payment rules apply | Separate payment rules apply | RVU13AR |
Where the South Carolina rate applies
South Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 475 cities and communities in South Carolina. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Abney Crossroads
- Adams Run
- Aiken
- Alcolu
- Allendale
- Anderson
- Andrews
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
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