FeeBase
Log inGet started
Menu

CPT code 98968: Telephone management, 21–30 minutes2026 Medicare rate & RVUs in Wisconsin

A qualified nonphysician health care professional reports this code for a 21–30-minute telephone assessment and management discussion with an established patient or representative.

CMS RVU26DEffective Oct 1, 2026One payment locality12.9K Medicare services in 2024

In Wisconsin, Medicare pays $33.90 for 98968 in the office and $28.46 when it’s performed in a hospital or facility.

$33.90Office (non-facility)
$28.46Hospital or facility
−2.4%vs the national office rate ($34.74)

Check a contract rate as a % of Medicare · 98968 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 98968 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Wisconsin
  2. What 98968 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 98968 covers

A qualified nonphysician health care professional uses this service to assess a patient’s concern by telephone and provide management advice or direction. The discussion may involve the patient or, when appropriate, a parent or guardian. It is a live telephone conversation, such as discussing symptoms, a medication concern, or next steps for an established patient; it is not an online portal exchange or self-management education session.

Select this code when the qualifying telephone service lasts 21–30 minutes; use 98966 or 98967 for the shorter time levels. Document the clinical issue, the assessment and management discussed, who participated, and the time spent in the telephone service. The service must not arise from a related evaluation and management service in the preceding seven days or lead to a related evaluation and management service or procedure within the following 24 hours or soonest available appointment.

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 Wisconsin compares for 98968

Across 109 of 109 payment localities, the office rate for 98968 runs from $33.14 in Arkansas to $47.55 in Alaska. Wisconsin pays $33.90. The RVUs are the same everywhere; the geographic indexes change the dollars.

98968 in Wisconsin vs other payment areas
  1. Wisconsin · this page$33.90
  2. Los Angeles, CA · California$37.19+$3.29
  3. Washington, DC area · District of Columbia$37.77+$3.87
  4. Miami, FL · Florida$36.13+$2.23
  5. Chicago, IL · Illinois$35.82+$1.92
  6. Manhattan, NY · New York$38.19+$4.29
  7. Alaska · Alaska$47.55+$13.65

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

Every other payment area

98968 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$33.32$28.35
ArkansasArkansas$33.14$28.26
ArizonaArizona$34.36$28.86
Bakersfield, CACalifornia$35.82$29.59
Chico, CACalifornia$35.72$29.50
El Centro, CACalifornia$35.72$29.50
Fresno, CACalifornia$35.72$29.50
Hanford, CACalifornia$35.72$29.50

98968 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$33.14

$47.55

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

View every state and territory as a table
98968 office rate range by state
State / territoryOffice rate rangeLocalities
AK$47.551
AL$33.321
AR$33.141
AZ$34.361
CA$35.72–$41.1729
CO$35.471
CT$36.071
DC$37.771
DE$34.691
FL$34.68–$36.133
GA$33.89–$35.092
GU$35.691
HI$35.691
IA$33.571
ID$33.661
IL$34.33–$35.824
IN$33.741
KS$33.541
KY$33.681
LA$33.67–$34.302
MA$35.48–$37.442
MD$35.04–$37.773
ME$33.76–$34.412
MI$34.04–$34.882
MN$34.531
MO$33.48–$34.313
MS$33.311
MT$34.741
NC$33.891
ND$34.341
NE$33.631
NH$35.021
NJ$36.63–$37.802
NM$34.121
NV$34.631
NY$34.09–$38.625
OH$33.961
OK$33.621
OR$34.50–$35.972
PA$33.96–$35.692
PR$34.831
RI$35.441
SC$33.951
SD$34.291
TN$33.611
TX$33.88–$35.238
UT$34.131
VA$34.39–$37.772
VI$34.831
VT$34.321
WA$35.38–$37.912
WI$33.901
WV$33.841
WY$34.561

See 98968 in every payment locality

How the 98968 rate is calculated

Each of 98968’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 · 98968

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.75

0.75 RVUs× 1.000 GPCI

Practice expense0.27

0.27 RVUs× 1.000 GPCI

Malpractice0.02

0.02 RVUs× 1.000 GPCI

Adjusted RVUs

1.0400

Conversion factor

$33.4009

Medicare rate

$34.74

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

The exact Wisconsin inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,951

Code
98968
Physician work
0.75
Practice expense
0.27
Malpractice
0.02

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 98968 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work0.75× 1.0000.7500
Practice expense0.27× 0.9580.2587
Malpractice0.02× 0.3080.0062
Total RVUs1.0148
Conversion factor× 33.4009

Office rate, Wisconsin$33.90

Office: (0.75 × 1 + 0.27 × 0.958 + 0.02 × 0.308) × $33.4009 = $33.90

Facility: (0.75 × 1 + 0.1 × 0.958 + 0.02 × 0.308) × $33.4009 = $28.46

Open 98968 in the RVU calculator

Payment rules and modifiers for 98968

98968 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 · 98968

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

$34.74

Non-facility (office)
$34.74
Facility
$29.06

Higher because the practice carries its own overhead.

Codes related to 98968

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

Codes related to 98968
CodeHow it relatesOffice range, Wisconsin
Same family
98966Telephone assessment, 5–10 minutesSame telephone assessment and management service at the 5–10-minute level.$13.25
98967Telephone assessment, 11–20 minutesSame telephone assessment and management service at the 11–20-minute level.$24.27
Used instead
98970Digital assessment, qualified nonphysician, 5–10 minutesOnline digital assessment and management uses an asynchronous exchange rather than a telephone discussion.$11.97
98960Self-management training, individual, per 30 minutesReports individual self-management education and training, rather than telephone assessment and management.No office rate

How 98968 has changed in Wisconsin

98968 · Office / nonfacility

$33.90

Effective 2026-10-01

The base rate is $1.69 higher than on 2025-10-01, moving from $32.21 to $33.90 (5.2%).

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

    $32.21changed to$33.90

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 0.25 changed to 0.27
    • Practice expense GPCI 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $32.19changed to$32.21

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 0.22 changed to 0.25

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $31.67changed to$32.19

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $32.71changed to$31.67

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense GPCI 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331

  5. January 1, 2023

    RVU23A

    $32.88changed to$32.71

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.20 changed to 0.22
    • Malpractice RVU 0.04 changed to 0.02
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $37.53changed to$32.88

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 0.33 changed to 0.20
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $39.07changed to$37.53

    • Conversion factor 36.0896 changed to 34.8931
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. April 1, 2020

    RVU20B

    No ratechanged to$39.07

    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$33.90$28.46RVU26D
2026-07-01$33.90$28.46RVU26C
2026-04-01$33.90$28.46RVU26B
2026-01-01$33.90$28.46RVU26A
2025-10-01$32.21$30.05RVU25D
2025-07-01$32.21$30.05RVU25C
2025-04-01$32.21$30.05RVU25B
2025-01-01$32.21$30.05RVU25A
2024-10-01$32.19$29.96RVU24D
2024-07-01$32.19$29.96RVU24C
2024-04-01$32.19$29.96RVU24B
2024-03-09$32.19$29.96RVU24AR
2024-01-01$31.67$29.48RVU24A
2023-10-01$32.71$30.46RVU23D
2023-07-01$32.71$30.46RVU23C
2023-04-01$32.71$30.46RVU23B
2023-01-01$32.71$30.46RVU23A
2022-10-01$32.88$30.93RVU22D
2022-07-01$32.88$30.93RVU22C
2022-04-01$32.88$30.93RVU22B
2022-01-01$32.88$30.93RVU22A
2021-10-01$37.53$36.22RVU21D
2021-07-01$37.53$36.22RVU21C
2021-04-01$37.53$36.22RVU21B
2021-01-01$37.53$36.22RVU21A
2020-10-01$39.07$37.70RVU20D
2020-07-01$39.07$37.70RVU20C
2020-04-01$39.07$37.70RVU20B
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 98968 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

  • Abbotsford
  • Abrams
  • Adams
  • Adell
  • Albany
  • Algoma
  • Allens Grove
  • Allenton

Browse all communities in Wisconsin

98968 billing questions

When should 98968 be selected instead of 98967?

Use 98968 for 21–30 minutes of qualifying telephone assessment and management. Code 98967 represents the 11–20-minute level.

Can the service be billed when a related office visit follows?

It is not separately reported when the telephone service leads to a related evaluation and management service or procedure within 24 hours or the soonest available appointment.

Does an online portal exchange qualify?

No. This code describes a telephone discussion; online digital assessment and management is represented by a different code family, including 98970–98972.

What should the record support?

Document the patient’s concern, the assessment and management provided, the participants, and 21–30 minutes spent on the telephone service.

Can a brief message or voicemail support 98968?

No. The service is a telephone assessment and management discussion, and the documented service time must meet the 21-minute minimum.

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 98968PPRRVU2026_Oct_nonQPP.csv, line 12,951 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 98968 pays in Wisconsin?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 98968 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist