CPT code 98970: Digital assessment, qualified nonphysician, 5–10 minutes2026 Medicare rate & RVUs in New Mexico
Reports a qualified nonphysician clinician’s online assessment and management of an established patient’s concern when cumulative service time is 5–10 minutes.
In New Mexico, Medicare pays $12.12 for 98970 in the office and $10.28 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 98970 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 98970 covers
A qualified nonphysician health care professional uses an online digital exchange to assess and manage a clinical concern raised by an established patient. The exchange may include reviewing the patient’s symptoms or records, evaluating the issue, and sending clinical guidance or arranging follow-up. A physical therapist, occupational therapist, or other qualified clinician may report the service when it falls within the professional’s scope. Routine scheduling, refill routing, and other administrative portal traffic are not clinical assessment and management.
Select this level when the professional’s cumulative time for the online service over the 7-day period is 5–10 minutes; the related levels cover longer time. The record should show the patient’s concern, the digital interaction, the clinical assessment and response, and the time accumulated during the period. The service is for an established patient and is distinct from telephone assessment and management, which uses the telephone-service code family.
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 New Mexico compares for 98970
Across 109 of 109 payment localities, the office rate for 98970 runs from $11.68 in Arkansas to $16.62 in Alaska. New Mexico pays $12.12. The RVUs are the same everywhere; the geographic indexes change the dollars.
- New Mexico · this page$12.12
- Los Angeles, CA · California$13.26+$1.14
- Washington, DC area · District of Columbia$13.50+$1.38
- Miami, FL · Florida$13.02+$0.90
- Chicago, IL · Illinois$12.87+$0.75
- Manhattan, NY · New York$13.68+$1.56
- Alaska · Alaska$16.62+$4.50
Other areas in New Mexico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $11.75 | $10.00 |
| ArkansasArkansas | $11.68 | $9.96 |
| ArizonaArizona | $12.20 | $10.25 |
| Bakersfield, CACalifornia | $12.74 | $10.54 |
| Chico, CACalifornia | $12.70 | $10.50 |
| El Centro, CACalifornia | $12.70 | $10.50 |
| Fresno, CACalifornia | $12.70 | $10.50 |
| Hanford, CACalifornia | $12.70 | $10.50 |
| Madera, CACalifornia | $12.70 | $10.50 |
| Merced, CACalifornia | $12.70 | $10.50 |
| Modesto, CACalifornia | $12.70 | $10.50 |
| Napa, CACalifornia | $13.89 | $11.25 |
| Oxnard, CACalifornia | $13.13 | $10.77 |
| Redding, CACalifornia | $12.70 | $10.50 |
| Rest of CaliforniaCalifornia | $12.70 | $10.50 |
| Riverside, CACalifornia | $12.81 | $10.62 |
| Sacramento, CACalifornia | $13.10 | $10.77 |
| Salinas, CACalifornia | $13.05 | $10.72 |
| San Diego, CACalifornia | $13.18 | $10.78 |
| Marin County, CACalifornia | $14.48 | $11.65 |
| San Francisco, CACalifornia | $14.47 | $11.64 |
| San Benito County, CACalifornia | $14.75 | $11.86 |
| Santa Clara County, CACalifornia | $14.70 | $11.81 |
| San Luis Obispo, CACalifornia | $12.86 | $10.57 |
| Santa Cruz, CACalifornia | $13.17 | $10.73 |
| Santa Maria, CACalifornia | $13.05 | $10.71 |
| Santa Rosa, CACalifornia | $13.29 | $10.83 |
| Stockton, CACalifornia | $12.70 | $10.50 |
| Vallejo, CACalifornia | $13.87 | $11.23 |
| Visalia, CACalifornia | $12.70 | $10.50 |
| Yuba City, CACalifornia | $12.70 | $10.50 |
| ColoradoColorado | $12.62 | $10.49 |
| ConnecticutConnecticut | $12.88 | $10.72 |
| DelawareDelaware | $12.32 | $10.34 |
| Fort Lauderdale, FLFlorida | $12.68 | $10.65 |
| Rest of FloridaFlorida | $12.36 | $10.45 |
| Atlanta, GAGeorgia | $12.51 | $10.47 |
| Rest of GeorgiaGeorgia | $12.03 | $10.24 |
| Hawaii, Guam, HIHawaii | $12.72 | $10.44 |
| IowaIowa | $11.84 | $10.01 |
| IdahoIdaho | $11.89 | $10.04 |
| East St. Louis, ILIllinois | $12.40 | $10.56 |
| Rest of IllinoisIllinois | $12.23 | $10.40 |
| Suburban Chicago, ILIllinois | $12.77 | $10.72 |
| IndianaIndiana | $11.92 | $10.06 |
| KansasKansas | $11.84 | $10.03 |
| KentuckyKentucky | $11.92 | $10.14 |
| New Orleans, LALouisiana | $12.19 | $10.30 |
| Rest of LouisianaLouisiana | $11.92 | $10.15 |
| Metropolitan Boston, MAMassachusetts | $13.38 | $10.98 |
| Rest of MassachusettsMassachusetts | $12.62 | $10.51 |
| Baltimore area, MDMaryland | $12.84 | $10.69 |
| Rest of MarylandMaryland | $12.46 | $10.43 |
| Rest of MaineMaine | $11.94 | $10.09 |
| Southern Maine, MEMaine | $12.20 | $10.22 |
| Detroit, MIMichigan | $12.46 | $10.52 |
| Rest of MichiganMichigan | $12.08 | $10.25 |
| MinnesotaMinnesota | $12.23 | $10.17 |
| Metropolitan Kansas City, MOMissouri | $12.13 | $10.24 |
| Metropolitan St. Louis, MOMissouri | $12.18 | $10.27 |
| Rest of MissouriMissouri | $11.84 | $10.12 |
| MississippiMississippi | $11.76 | $10.03 |
| MontanaMontana | $12.36 | $10.35 |
| North CarolinaNorth Carolina | $11.99 | $10.12 |
| North DakotaNorth Dakota | $12.16 | $10.16 |
| NebraskaNebraska | $11.87 | $10.02 |
| New HampshireNew Hampshire | $12.47 | $10.38 |
| Northern New JerseyNew Jersey | $13.49 | $11.17 |
| Rest of New JerseyNew Jersey | $13.06 | $10.87 |
| NevadaNevada | $12.31 | $10.30 |
| NYC suburbs and Long Island, NYNew York | $13.87 | $11.49 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $13.15 | $10.96 |
| Queens, NYNew York | $13.71 | $11.34 |
| Rest of New YorkNew York | $12.08 | $10.17 |
| OhioOhio | $12.04 | $10.21 |
| OklahomaOklahoma | $11.89 | $10.10 |
| Portland, OROregon | $12.81 | $10.59 |
| Rest of OregonOregon | $12.24 | $10.25 |
| Metropolitan Philadelphia, PAPennsylvania | $12.72 | $10.64 |
| Rest of PennsylvaniaPennsylvania | $12.04 | $10.20 |
| Puerto RicoPuerto Rico | $12.39 | $10.37 |
| Rhode IslandRhode Island | $12.60 | $10.53 |
| South CarolinaSouth Carolina | $12.03 | $10.18 |
| South DakotaSouth Dakota | $12.14 | $10.13 |
| TennesseeTennessee | $11.87 | $10.05 |
| Austin, TXTexas | $12.55 | $10.43 |
| Beaumont, TXTexas | $12.00 | $10.18 |
| Brazoria, TXTexas | $12.32 | $10.33 |
| Dallas, TXTexas | $12.37 | $10.38 |
| Fort Worth, TXTexas | $12.34 | $10.36 |
| Galveston, TXTexas | $12.34 | $10.35 |
| Houston, TXTexas | $12.53 | $10.53 |
| Rest of TexasTexas | $12.14 | $10.24 |
| UtahUtah | $12.10 | $10.22 |
| VirginiaVirginia | $12.20 | $10.23 |
| Virgin Islands, VIUnited States Virgin Islands | $12.39 | $10.37 |
| VermontVermont | $12.16 | $10.17 |
| Rest of WashingtonWashington | $12.58 | $10.47 |
| King County, WAWashington | $13.55 | $11.09 |
| WisconsinWisconsin | $11.97 | $10.05 |
| West VirginiaWest Virginia | $12.02 | $10.28 |
| WyomingWyoming | $12.27 | $10.27 |
98970 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.
$11.68
$16.62
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 | $16.62 | 1 |
| AL | $11.75 | 1 |
| AR | $11.68 | 1 |
| AZ | $12.20 | 1 |
| CA | $12.70–$14.75 | 29 |
| CO | $12.62 | 1 |
| CT | $12.88 | 1 |
| DC | $13.50 | 1 |
| DE | $12.32 | 1 |
| FL | $12.36–$13.02 | 3 |
| GA | $12.03–$12.51 | 2 |
| GU | $12.72 | 1 |
| HI | $12.72 | 1 |
| IA | $11.84 | 1 |
| ID | $11.89 | 1 |
| IL | $12.23–$12.87 | 4 |
| IN | $11.92 | 1 |
| KS | $11.84 | 1 |
| KY | $11.92 | 1 |
| LA | $11.92–$12.19 | 2 |
| MA | $12.62–$13.38 | 2 |
| MD | $12.46–$13.50 | 3 |
| ME | $11.94–$12.20 | 2 |
| MI | $12.08–$12.46 | 2 |
| MN | $12.23 | 1 |
| MO | $11.84–$12.18 | 3 |
| MS | $11.76 | 1 |
| MT | $12.36 | 1 |
| NC | $11.99 | 1 |
| ND | $12.16 | 1 |
| NE | $11.87 | 1 |
| NH | $12.47 | 1 |
| NJ | $13.06–$13.49 | 2 |
| NM | $12.12 | 1 |
| NV | $12.31 | 1 |
| NY | $12.08–$13.87 | 5 |
| OH | $12.04 | 1 |
| OK | $11.89 | 1 |
| OR | $12.24–$12.81 | 2 |
| PA | $12.04–$12.72 | 2 |
| PR | $12.39 | 1 |
| RI | $12.60 | 1 |
| SC | $12.03 | 1 |
| SD | $12.14 | 1 |
| TN | $11.87 | 1 |
| TX | $12.00–$12.55 | 8 |
| UT | $12.10 | 1 |
| VA | $12.20–$13.50 | 2 |
| VI | $12.39 | 1 |
| VT | $12.16 | 1 |
| WA | $12.58–$13.55 | 2 |
| WI | $11.97 | 1 |
| WV | $12.02 | 1 |
| WY | $12.27 | 1 |
How the 98970 rate is calculated
Each of 98970’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 · 98970
RVUs × geographic indexes × conversion factor
Work0.25
0.25 RVUs× 1.000 GPCI
Practice expense0.11
0.11 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.3700
Conversion factor
$33.4009
Medicare rate
$12.36
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact New Mexico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,952
- Code
- 98970
- Physician work
- 0.25
- Practice expense
- 0.11
- Malpractice
- 0.01
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.25 | × 1.000 | 0.2500 |
| Practice expense | 0.11 | × 0.917 | 0.1009 |
| Malpractice | 0.01 | × 1.201 | 0.0120 |
| Total RVUs | 0.3629 | ||
| Conversion factor | × 33.4009 | ||
Office rate, New Mexico$12.12
Office: (0.25 × 1 + 0.11 × 0.917 + 0.01 × 1.201) × $33.4009 = $12.12
Facility: (0.25 × 1 + 0.05 × 0.917 + 0.01 × 1.201) × $33.4009 = $10.28
Payment rules and modifiers for 98970
98970 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 · 98970
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$12.36
- Non-facility (office)
- $12.36
- Facility
- $10.35
Higher because the practice carries its own overhead.
How 98970 has changed in New Mexico
98970 · Office / nonfacility
$12.12
Effective 2026-10-01
The base rate is $1.01 higher than on 2025-10-01, moving from $11.11 to $12.12 (9.1%).
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
$11.11changed to$12.12
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.09 changed to 0.11
- Practice expense GPCI 0.908 changed to 0.917
- Malpractice GPCI 1.172 changed to 1.201
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$11.43changed to$11.11
- Conversion factor 33.2875 changed to 32.3465
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$11.25changed to$11.43
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$11.31changed to$11.25
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.08 changed to 0.09
- Practice expense GPCI 0.902 changed to 0.908
- Malpractice GPCI 1.169 changed to 1.172
January 1, 2023
RVU23A
$11.54changed to$11.31
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 1.166 changed to 1.169
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$11.63changed to$11.54
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
No ratechanged to$11.63
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
No ratechanged toNo rate
Held through RVU20B, 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.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $12.12 | $10.28 | RVU26D |
| 2026-07-01 | $12.12 | $10.28 | RVU26C |
| 2026-04-01 | $12.12 | $10.28 | RVU26B |
| 2026-01-01 | $12.12 | $10.28 | RVU26A |
| 2025-10-01 | $11.11 | $11.11 | RVU25D |
| 2025-07-01 | $11.11 | $11.11 | RVU25C |
| 2025-04-01 | $11.11 | $11.11 | RVU25B |
| 2025-01-01 | $11.11 | $11.11 | RVU25A |
| 2024-10-01 | $11.43 | $11.43 | RVU24D |
| 2024-07-01 | $11.43 | $11.43 | RVU24C |
| 2024-04-01 | $11.43 | $11.43 | RVU24B |
| 2024-03-09 | $11.43 | $11.43 | RVU24AR |
| 2024-01-01 | $11.25 | $11.25 | RVU24A |
| 2023-10-01 | $11.31 | $11.31 | RVU23D |
| 2023-07-01 | $11.31 | $11.31 | RVU23C |
| 2023-04-01 | $11.31 | $11.31 | RVU23B |
| 2023-01-01 | $11.31 | $11.31 | RVU23A |
| 2022-10-01 | $11.54 | $11.54 | RVU22D |
| 2022-07-01 | $11.54 | $11.54 | RVU22C |
| 2022-04-01 | $11.54 | $11.54 | RVU22B |
| 2022-01-01 | $11.54 | $11.54 | RVU22A |
| 2021-10-01 | $11.63 | $11.32 | RVU21D |
| 2021-07-01 | $11.63 | $11.32 | RVU21C |
| 2021-04-01 | $11.63 | $11.32 | RVU21B |
| 2021-01-01 | $11.63 | $11.32 | RVU21A |
| 2020-10-01 | Separate payment rules apply | Separate payment rules apply | RVU20D |
| 2020-07-01 | Separate payment rules apply | Separate payment rules apply | RVU20C |
| 2020-04-01 | Separate payment rules apply | Separate payment rules apply | RVU20B |
| 2020-01-01 | Separate payment rules apply | Separate payment rules apply | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the New Mexico rate applies
New Mexico is a Medicare payment area, not a city. Our Census mapping connects it to 528 cities and communities in New Mexico. Some span more than one payment area; confirm with the service ZIP.
- Abeytas
- Abiquiu
- Acomita Lake
- Adelino
- Agua Fria
- Alamillo
- Alamo
- Alamogordo
98970 billing questions
How is 98970 distinguished from 98971 and 98972?
Choose among these online digital service levels by the qualified professional’s cumulative time over the 7-day period. 98970 covers 5–10 minutes; 98971 and 98972 represent the longer time levels.
Can a phone call count toward 98970?
No. 98970 describes online digital assessment and management; telephone assessment and management by a qualified nonphysician professional is reported from 98966–98968 when applicable.
What documentation supports reporting this service?
Document the established patient’s clinical concern, the online exchange and clinical response, and the professional’s cumulative time for the 7-day period.
Do routine portal messages qualify?
No. Scheduling, administrative requests, and messages without clinical assessment and management do not describe this service.
Can the digital work be separately reported when it leads to an office visit?
When the digital assessment is related to an E/M service in the preceding 7 days or leads to an E/M service within 24 hours or the soonest available appointment, the work is included in that E/M service.
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
Fee sheets · Coming soon
Put 98970 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
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