Billing code 98971: Digital assessmentMedicare rate & RVUs

Medicare pays $23.05 for 98971 nationally in the office and $19.04 in a hospital or facility. Local office rates run $21.64–$30.59.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

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.

Where 98971 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

98971 rates by state

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

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.

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.

98971 compared with similar codes

How to choose

98970Digital assessment

Use 98970 when cumulative digital assessment and management time is 5-10 minutes; 98971 requires 11-20 minutes.

98972Digital assessment

Use 98972 when cumulative digital assessment and management time reaches 21 minutes or more; 98971 is for 11-20 minutes.

98967Telephone assessment

Both cover 11-20 minutes of qualified nonphysician professional assessment and management, but 98967 is for telephone service and 98971 is for online digital communication.

99421Online E/M

99421 is the 5-10-minute online digital evaluation and management level in the physician or other qualified health care professional code family; 98971 is the 11-20-minute level for a qualified nonphysician health care professional.

Codes related to 98971

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

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

Open CMS sourceHow we calculate rates