$12.72
Use 98970 when cumulative digital assessment and management time is 5-10 minutes; 98971 requires 11-20 minutes.
On this page
CMS RVU26D · Effective 2026-10-01
98971 Digital assessment Medicare reimbursement rates in Guam
Reports qualified nonphysician health care professional assessment and management through online digital communication when cumulative clinician time reaches 11-20 minutes over seven days. Compare 98971 office and facility rates across CMS payment localities in Guam.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 98971 in Guam?
Guam has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$23.82
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
$19.26
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Digital assessment
About 98971: Online digital assessment and management, 11-20 minutes
Reports qualified nonphysician health care professional assessment and management through online digital communication when cumulative clinician time reaches 11-20 minutes over seven days.
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.
Where the value comes from
- Work RVU0.44 · 64%
- Practice expense (office) RVU0.23 · 33%
- Malpractice RVU0.02 · 3%
785
Medicare services in 2024 · #3167 by national volume
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.
98971 compared with similar codes
Office rates for Guam, from the same CMS release.
$35.40
Use 98972 when cumulative digital assessment and management time reaches 21 minutes or more; 98971 is for 11-20 minutes.
$25.82
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.
$16.33
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.
Compare 98971 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Hawaii, Guam →
Office / nonfacility
$23.82
Facility
$19.26
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 98971 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,953
- Code
- 98971
- Physician work
- 0.44
- Practice expense
- 0.23
- Malpractice
- 0.02
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.44 | × 1.000 | 0.4400 |
| Practice expense | 0.23 | × 1.137 | 0.2615 |
| Malpractice | 0.02 | × 0.579 | 0.0116 |
| Total RVUs | 0.7131 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$23.82
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.44 | 1 |
| Practice expense | 0.23 | 1.137 |
| Malpractice | 0.02 | 0.579 |
(0.44 × 1 + 0.23 × 1.137 + 0.02 × 0.579) × $33.4009 = $23.82
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.44 | 1 |
| Practice expense | 0.11 | 1.137 |
| Malpractice | 0.02 | 0.579 |
(0.44 × 1 + 0.11 × 1.137 + 0.02 × 0.579) × $33.4009 = $19.26
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,95098967,,Ph1 assmt&mgmt nqhp 11-20,A,,0.50,0.23,,0.08,,0.02,0.75,0.60,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95198968,,Ph1 assmt&mgmt nqhp 21-30,A,,0.75,0.27,,0.10,,0.02,1.04,0.87,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95298970,,Nqhp ol dig assmt&mgmt 5-10,A,,0.25,0.11,,0.05,,0.01,0.37,0.31,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95398971,,Nqhp ol dig assmt&mgmt 11-20,A,,0.44,0.23,,0.11,,0.02,0.69,0.57,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95498972,,Nqhp ol dig assmt&mgmt 21+,A,,0.69,0.31,,0.15,,0.03,1.03,0.87,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95598975,,Rtm 1st set-up&pt educaj eqp,A,,0.00,0.63,,0.63,NA,0.02,0.65,0.65,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,95698976,,Rtm dev sply resp sys 16-30d,A,,0.00,1.55,,1.55,NA,0.01,1.56,1.56,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014