CPT code 98971: Digital assessment, 11-20 minutes2026 Medicare rate & RVUs in Puerto Rico
Reports qualified nonphysician health care professional assessment and management through online digital communication when cumulative clinician time reaches 11-20 minutes over seven days.
In Puerto Rico, Medicare pays $23.12 for 98971 in the office and $19.07 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 98971 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 98971 covers
A qualified nonphysician health care professional uses online digital communication to assess and manage an established patient’s health concern. The service may include reviewing the patient’s submitted information, evaluating the issue, and communicating a clinical assessment or management plan through a patient portal or similar digital platform. It is distinct from a telephone assessment and management service, even when both address a similar concern.
Select this level when the professional’s cumulative time performing the qualifying digital assessment and management reaches 11-20 minutes during the seven-day period. The patient’s messages and the professional’s clinical work should support the concern addressed, the assessment or management provided, and the time counted. Report the service for the digital episode rather than assigning separate units to each message. CMS values the service through work, practice-expense, and malpractice relative value units in the Physician Fee Schedule.
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 Puerto Rico compares for 98971
Across 109 of 109 payment localities, the office rate for 98971 runs from $21.64 in Arkansas to $30.59 in Alaska. Puerto Rico pays $23.12. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$23.12
- Los Angeles, CA · California$24.83+$1.71
- Washington, DC area · District of Columbia$25.28+$2.16
- Miami, FL · Florida$24.38+$1.26
- Chicago, IL · Illinois$24.05+$0.93
- Manhattan, NY · New York$25.62+$2.50
- Alaska · Alaska$30.59+$7.47
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $21.80 | $18.29 |
| ArkansasArkansas | $21.64 | $18.20 |
| ArizonaArizona | $22.71 | $18.83 |
| Bakersfield, CACalifornia | $23.80 | $19.41 |
| Chico, CACalifornia | $23.72 | $19.33 |
| El Centro, CACalifornia | $23.73 | $19.33 |
| Fresno, CACalifornia | $23.72 | $19.33 |
| Hanford, CACalifornia | $23.72 | $19.33 |
| Madera, CACalifornia | $23.72 | $19.33 |
| Merced, CACalifornia | $23.72 | $19.33 |
| Modesto, CACalifornia | $23.72 | $19.33 |
| Napa, CACalifornia | $26.09 | $20.80 |
| Oxnard, CACalifornia | $24.60 | $19.87 |
| Redding, CACalifornia | $23.72 | $19.33 |
| Rest of CaliforniaCalifornia | $23.72 | $19.33 |
| Riverside, CACalifornia | $23.95 | $19.56 |
| Sacramento, CACalifornia | $24.52 | $19.86 |
| Salinas, CACalifornia | $24.41 | $19.77 |
| San Diego, CACalifornia | $24.69 | $19.89 |
| Marin County, CACalifornia | $27.23 | $21.58 |
| San Francisco, CACalifornia | $27.21 | $21.56 |
| San Benito County, CACalifornia | $27.75 | $21.97 |
| Santa Clara County, CACalifornia | $27.66 | $21.88 |
| San Luis Obispo, CACalifornia | $24.05 | $19.49 |
| Santa Cruz, CACalifornia | $24.70 | $19.83 |
| Santa Maria, CACalifornia | $24.42 | $19.75 |
| Santa Rosa, CACalifornia | $24.93 | $20.01 |
| Stockton, CACalifornia | $23.72 | $19.33 |
| Vallejo, CACalifornia | $26.05 | $20.77 |
| Visalia, CACalifornia | $23.72 | $19.33 |
| Yuba City, CACalifornia | $23.72 | $19.33 |
| ColoradoColorado | $23.57 | $19.30 |
| ConnecticutConnecticut | $24.07 | $19.76 |
| DelawareDelaware | $22.96 | $19.00 |
| Fort Lauderdale, FLFlorida | $23.69 | $19.63 |
| Rest of FloridaFlorida | $23.04 | $19.21 |
| Atlanta, GAGeorgia | $23.35 | $19.28 |
| Rest of GeorgiaGeorgia | $22.35 | $18.77 |
| Hawaii, Guam, HIHawaii | $23.82 | $19.26 |
| IowaIowa | $21.99 | $18.32 |
| IdahoIdaho | $22.08 | $18.39 |
| East St. Louis, ILIllinois | $23.11 | $19.42 |
| Rest of IllinoisIllinois | $22.75 | $19.09 |
| Suburban Chicago, ILIllinois | $23.87 | $19.76 |
| IndianaIndiana | $22.14 | $18.43 |
| KansasKansas | $21.98 | $18.35 |
| KentuckyKentucky | $22.14 | $18.57 |
| New Orleans, LALouisiana | $22.68 | $18.91 |
| Rest of LouisianaLouisiana | $22.14 | $18.59 |
| Metropolitan Boston, MAMassachusetts | $25.07 | $20.28 |
| Rest of MassachusettsMassachusetts | $23.55 | $19.33 |
| Baltimore area, MDMaryland | $24.00 | $19.70 |
| Rest of MarylandMaryland | $23.23 | $19.17 |
| Rest of MaineMaine | $22.18 | $18.49 |
| Southern Maine, MEMaine | $22.73 | $18.76 |
| Detroit, MIMichigan | $23.24 | $19.37 |
| Rest of MichiganMichigan | $22.46 | $18.81 |
| MinnesotaMinnesota | $22.80 | $18.67 |
| Metropolitan Kansas City, MOMissouri | $22.56 | $18.80 |
| Metropolitan St. Louis, MOMissouri | $22.68 | $18.86 |
| Rest of MissouriMissouri | $21.97 | $18.51 |
| MississippiMississippi | $21.80 | $18.35 |
| MontanaMontana | $23.05 | $19.04 |
| North CarolinaNorth Carolina | $22.29 | $18.55 |
| North DakotaNorth Dakota | $22.65 | $18.64 |
| NebraskaNebraska | $22.04 | $18.34 |
| New HampshireNew Hampshire | $23.28 | $19.11 |
| Northern New JerseyNew Jersey | $25.25 | $20.60 |
| Rest of New JerseyNew Jersey | $24.41 | $20.03 |
| New MexicoNew Mexico | $22.54 | $18.87 |
| NevadaNevada | $22.94 | $18.93 |
| NYC suburbs and Long Island, NYNew York | $26.01 | $21.25 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $24.58 | $20.19 |
| Queens, NYNew York | $25.68 | $20.94 |
| Rest of New YorkNew York | $22.46 | $18.66 |
| OhioOhio | $22.38 | $18.72 |
| OklahomaOklahoma | $22.08 | $18.50 |
| Portland, OROregon | $23.96 | $19.51 |
| Rest of OregonOregon | $22.82 | $18.83 |
| Metropolitan Philadelphia, PAPennsylvania | $23.76 | $19.58 |
| Rest of PennsylvaniaPennsylvania | $22.38 | $18.70 |
| Rhode IslandRhode Island | $23.51 | $19.37 |
| South CarolinaSouth Carolina | $22.36 | $18.66 |
| South DakotaSouth Dakota | $22.60 | $18.59 |
| TennesseeTennessee | $22.04 | $18.39 |
| Austin, TXTexas | $23.45 | $19.20 |
| Beaumont, TXTexas | $22.31 | $18.66 |
| Brazoria, TXTexas | $22.95 | $18.98 |
| Dallas, TXTexas | $23.05 | $19.06 |
| Fort Worth, TXTexas | $22.99 | $19.03 |
| Galveston, TXTexas | $23.00 | $19.02 |
| Houston, TXTexas | $23.36 | $19.38 |
| Rest of TexasTexas | $22.59 | $18.79 |
| UtahUtah | $22.52 | $18.75 |
| VirginiaVirginia | $22.72 | $18.78 |
| Virgin Islands, VIUnited States Virgin Islands | $23.12 | $19.07 |
| VermontVermont | $22.64 | $18.67 |
| Rest of WashingtonWashington | $23.49 | $19.26 |
| King County, WAWashington | $25.40 | $20.49 |
| WisconsinWisconsin | $22.26 | $18.42 |
| West VirginiaWest Virginia | $22.33 | $18.85 |
| WyomingWyoming | $22.87 | $18.86 |
98971 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.
$21.64
$30.59
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 | $30.59 | 1 |
| AL | $21.80 | 1 |
| AR | $21.64 | 1 |
| AZ | $22.71 | 1 |
| CA | $23.72–$27.75 | 29 |
| CO | $23.57 | 1 |
| CT | $24.07 | 1 |
| DC | $25.28 | 1 |
| DE | $22.96 | 1 |
| FL | $23.04–$24.38 | 3 |
| GA | $22.35–$23.35 | 2 |
| GU | $23.82 | 1 |
| HI | $23.82 | 1 |
| IA | $21.99 | 1 |
| ID | $22.08 | 1 |
| IL | $22.75–$24.05 | 4 |
| IN | $22.14 | 1 |
| KS | $21.98 | 1 |
| KY | $22.14 | 1 |
| LA | $22.14–$22.68 | 2 |
| MA | $23.55–$25.07 | 2 |
| MD | $23.23–$25.28 | 3 |
| ME | $22.18–$22.73 | 2 |
| MI | $22.46–$23.24 | 2 |
| MN | $22.80 | 1 |
| MO | $21.97–$22.68 | 3 |
| MS | $21.80 | 1 |
| MT | $23.05 | 1 |
| NC | $22.29 | 1 |
| ND | $22.65 | 1 |
| NE | $22.04 | 1 |
| NH | $23.28 | 1 |
| NJ | $24.41–$25.25 | 2 |
| NM | $22.54 | 1 |
| NV | $22.94 | 1 |
| NY | $22.46–$26.01 | 5 |
| OH | $22.38 | 1 |
| OK | $22.08 | 1 |
| OR | $22.82–$23.96 | 2 |
| PA | $22.38–$23.76 | 2 |
| PR | $23.12 | 1 |
| RI | $23.51 | 1 |
| SC | $22.36 | 1 |
| SD | $22.60 | 1 |
| TN | $22.04 | 1 |
| TX | $22.31–$23.45 | 8 |
| UT | $22.52 | 1 |
| VA | $22.72–$25.28 | 2 |
| VI | $23.12 | 1 |
| VT | $22.64 | 1 |
| WA | $23.49–$25.40 | 2 |
| WI | $22.26 | 1 |
| WV | $22.33 | 1 |
| WY | $22.87 | 1 |
How the 98971 rate is calculated
Each of 98971’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 · 98971
RVUs × geographic indexes × conversion factor
Work0.44
0.44 RVUs× 1.000 GPCI
Practice expense0.23
0.23 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.6900
Conversion factor
$33.4009
Medicare rate
$23.05
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,953
- Code
- 98971
- Physician work
- 0.44
- Practice expense
- 0.23
- Malpractice
- 0.02
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.44 | × 1.000 | 0.4400 |
| Practice expense | 0.23 | × 1.011 | 0.2325 |
| Malpractice | 0.02 | × 0.985 | 0.0197 |
| Total RVUs | 0.6922 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$23.12
Office: (0.44 × 1 + 0.23 × 1.011 + 0.02 × 0.985) × $33.4009 = $23.12
Facility: (0.44 × 1 + 0.11 × 1.011 + 0.02 × 0.985) × $33.4009 = $19.07
Payment rules and modifiers for 98971
98971 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 · 98971
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$23.05
- Non-facility (office)
- $23.05
- Facility
- $19.04
Higher because the practice carries its own overhead.
How 98971 has changed in Puerto Rico
98971 · Office / nonfacility
$23.12
Effective 2026-10-01
The base rate is $1.75 higher than on 2025-10-01, moving from $21.37 to $23.12 (8.2%).
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
$21.37changed to$23.12
- Conversion factor 32.3465 changed to 33.4009
- Practice expense RVU 0.19 changed to 0.23
- Malpractice RVU 0.03 changed to 0.02
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$20.66changed to$21.37
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 0.16 changed to 0.19
- Malpractice RVU 0.02 changed to 0.03
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$20.33changed to$20.66
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$20.37changed to$20.33
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 0.15 changed to 0.16
- Malpractice RVU 0.01 changed to 0.02
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$20.33changed to$20.37
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$20.79changed to$20.33
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 0.14 changed to 0.15
- Malpractice RVU 0.02 changed to 0.01
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$20.97changed to$20.79
- Conversion factor 34.8931 changed to 34.6062
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
No ratechanged to$20.97
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 | $23.12 | $19.07 | RVU26D |
| 2026-07-01 | $23.12 | $19.07 | RVU26C |
| 2026-04-01 | $23.12 | $19.07 | RVU26B |
| 2026-01-01 | $23.12 | $19.07 | RVU26A |
| 2025-10-01 | $21.37 | $21.37 | RVU25D |
| 2025-07-01 | $21.37 | $21.37 | RVU25C |
| 2025-04-01 | $21.37 | $21.37 | RVU25B |
| 2025-01-01 | $21.37 | $21.37 | RVU25A |
| 2024-10-01 | $20.66 | $20.66 | RVU24D |
| 2024-07-01 | $20.66 | $20.66 | RVU24C |
| 2024-04-01 | $20.66 | $20.66 | RVU24B |
| 2024-03-09 | $20.66 | $20.66 | RVU24AR |
| 2024-01-01 | $20.33 | $20.33 | RVU24A |
| 2023-10-01 | $20.37 | $20.03 | RVU23D |
| 2023-07-01 | $20.33 | $19.99 | RVU23C |
| 2023-04-01 | $20.33 | $19.99 | RVU23B |
| 2023-01-01 | $20.33 | $19.99 | RVU23A |
| 2022-10-01 | $20.79 | $20.44 | RVU22D |
| 2022-07-01 | $20.79 | $20.44 | RVU22C |
| 2022-04-01 | $20.79 | $20.44 | RVU22B |
| 2022-01-01 | $20.79 | $20.44 | RVU22A |
| 2021-10-01 | $20.97 | $20.61 | RVU21D |
| 2021-07-01 | $20.97 | $20.61 | RVU21C |
| 2021-04-01 | $20.97 | $20.61 | RVU21B |
| 2021-01-01 | $20.97 | $20.61 | 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 Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
98971 billing questions
How does 98971 differ from 98970 and 98972?
The distinction is cumulative professional time during the seven-day period: 98970 covers 5-10 minutes, 98971 covers 11-20 minutes, and 98972 covers 21 minutes or more.
Can the service be reported for a phone call?
No. This code is for online digital assessment and management; telephone assessment and management by a qualified nonphysician professional is represented by 98966-98968.
How is time counted when there are several messages?
Combine the professional’s qualifying time spent on the digital assessment and management during the seven-day period. Do not count the patient’s elapsed time between messages as professional time.
What documentation supports 98971?
Record the patient’s digital concern, the professional’s assessment or management, the communication provided, and the cumulative time supporting the 11-20-minute level.
Can a physician report 98971?
This code is for an online digital assessment and management service performed by a qualified nonphysician health care professional. Physician online digital evaluation and management is represented by a separate code family, including 99421-99423.
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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