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.

CMS RVU26DEffective Oct 1, 2026One payment locality785 Medicare services in 2024

In Puerto Rico, Medicare pays $23.12 for 98971 in the office and $19.07 when it’s performed in a hospital or facility.

$23.12Office (non-facility)
$19.07Hospital or facility
+0.3%vs the national office rate ($23.05)

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.

We’ll open 98971 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 98971 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 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.

98971 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$23.12
  2. Los Angeles, CA · California$24.83+$1.71
  3. Washington, DC area · District of Columbia$25.28+$2.16
  4. Miami, FL · Florida$24.38+$1.26
  5. Chicago, IL · Illinois$24.05+$0.93
  6. Manhattan, NY · New York$25.62+$2.50
  7. Alaska · Alaska$30.59+$7.47

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

Every other payment area

98971 in every other Medicare payment locality
Payment localityOfficeFacility
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

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
98971 office rate range by state
State / territoryOffice rate rangeLocalities
AK$30.591
AL$21.801
AR$21.641
AZ$22.711
CA$23.72–$27.7529
CO$23.571
CT$24.071
DC$25.281
DE$22.961
FL$23.04–$24.383
GA$22.35–$23.352
GU$23.821
HI$23.821
IA$21.991
ID$22.081
IL$22.75–$24.054
IN$22.141
KS$21.981
KY$22.141
LA$22.14–$22.682
MA$23.55–$25.072
MD$23.23–$25.283
ME$22.18–$22.732
MI$22.46–$23.242
MN$22.801
MO$21.97–$22.683
MS$21.801
MT$23.051
NC$22.291
ND$22.651
NE$22.041
NH$23.281
NJ$24.41–$25.252
NM$22.541
NV$22.941
NY$22.46–$26.015
OH$22.381
OK$22.081
OR$22.82–$23.962
PA$22.38–$23.762
PR$23.121
RI$23.511
SC$22.361
SD$22.601
TN$22.041
TX$22.31–$23.458
UT$22.521
VA$22.72–$25.282
VI$23.121
VT$22.641
WA$23.49–$25.402
WI$22.261
WV$22.331
WY$22.871

See 98971 in every payment locality

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

Office or facility?

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
Office calculation for 98971 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.44× 1.0000.4400
Practice expense0.23× 1.0110.2325
Malpractice0.02× 0.9850.0197
Total RVUs0.6922
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

Open 98971 in the RVU calculator

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.

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

    $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.

  2. 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.

  3. March 9, 2024

    RVU24AR

    $20.33changed to$20.66

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. 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
  5. 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
  6. 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.

  7. January 1, 2022

    RVU22A

    $20.97changed to$20.79

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    No ratechanged to$20.97

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    No ratechanged toNo rate

    Held through RVU20B, RVU20C, RVU20D.

  10. 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.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$23.12$19.07RVU26D
2026-07-01$23.12$19.07RVU26C
2026-04-01$23.12$19.07RVU26B
2026-01-01$23.12$19.07RVU26A
2025-10-01$21.37$21.37RVU25D
2025-07-01$21.37$21.37RVU25C
2025-04-01$21.37$21.37RVU25B
2025-01-01$21.37$21.37RVU25A
2024-10-01$20.66$20.66RVU24D
2024-07-01$20.66$20.66RVU24C
2024-04-01$20.66$20.66RVU24B
2024-03-09$20.66$20.66RVU24AR
2024-01-01$20.33$20.33RVU24A
2023-10-01$20.37$20.03RVU23D
2023-07-01$20.33$19.99RVU23C
2023-04-01$20.33$19.99RVU23B
2023-01-01$20.33$19.99RVU23A
2022-10-01$20.79$20.44RVU22D
2022-07-01$20.79$20.44RVU22C
2022-04-01$20.79$20.44RVU22B
2022-01-01$20.79$20.44RVU22A
2021-10-01$20.97$20.61RVU21D
2021-07-01$20.97$20.61RVU21C
2021-04-01$20.97$20.61RVU21B
2021-01-01$20.97$20.61RVU21A
2020-10-01Separate payment rules applySeparate payment rules applyRVU20D
2020-07-01Separate payment rules applySeparate payment rules applyRVU20C
2020-04-01Separate payment rules applySeparate payment rules applyRVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Not in this releaseNot in this releaseRVU19D
2019-07-01Not in this releaseNot in this releaseRVU19C
2019-04-01Not in this releaseNot in this releaseRVU19B
2019-01-01Not in this releaseNot in this releaseRVU19A
2018-10-01Not in this releaseNot in this releaseRVU18D
2018-07-01Not in this releaseNot in this releaseRVU18C
2018-04-01Not in this releaseNot in this releaseRVU18B
2018-01-01Not in this releaseNot in this releaseRVU18AR1
2017-10-01Not in this releaseNot in this releaseRVU17D
2017-07-01Not in this releaseNot in this releaseRVU17C
2017-04-01Not in this releaseNot in this releaseRVU17B
2017-01-01Not in this releaseNot in this releaseRVU17A
2016-10-01Not in this releaseNot in this releaseRVU16D
2016-07-01Not in this releaseNot in this releaseRVU16C
2016-04-01Not in this releaseNot in this releaseRVU16B
2016-01-01Not in this releaseNot in this releaseRVU16A
2015-10-01Not in this releaseNot in this releaseRVU15D
2015-07-01Not in this releaseNot in this releaseRVU15C
2015-04-01Not in this releaseNot in this releaseRVU15B
2015-01-01Not in this releaseNot in this releaseRVU15A
2014-10-01Not in this releaseNot in this releaseRVU14D
2014-07-01Not in this releaseNot in this releaseRVU14C
2014-04-01Not in this releaseNot in this releaseRVU14B
2014-01-01Not in this releaseNot in this releaseRVU14A
2013-10-01Not in this releaseNot in this releaseRVU13D
2013-07-01Not in this releaseNot in this releaseRVU13C
2013-04-01Not in this releaseNot in this releaseRVU13B
2013-01-01Not in this releaseNot in this releaseRVU13AR

Price 98971 for an earlier date of service

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

Browse all communities in Puerto Rico

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
RVUs for 98971PPRRVU2026_Oct_nonQPP.csv, line 12,953 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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