$33.12
Use 98925 when OMT treats one or two distinct regions. Use 98926 when it treats three or four.
On this page
CMS RVU26D · Effective 2026-10-01
98926 Osteopathic manipulation Medicare reimbursement rates in Rhode Island
Report this service when a physician performs osteopathic manipulative treatment on three or four distinct body regions for documented somatic dysfunction. Compare 98926 office and facility rates across CMS payment localities in Rhode Island.
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 98926 in Rhode Island?
Rhode Island 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
$47.10
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
Facility setting
$30.20
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Osteopathic treatment
About 98926: Osteopathic manipulative treatment, 3-4 regions
Report this service when a physician performs osteopathic manipulative treatment on three or four distinct body regions for documented somatic dysfunction.
A physician, commonly an osteopathic physician, uses manual techniques to treat somatic dysfunction in three or four body regions during an office visit or other clinical encounter. The regions may include the head, neck, thoracic or lumbar areas, sacrum, pelvis, ribs, abdomen, or upper or lower extremities. The code reflects the number of distinct regions treated, not the number of techniques used or the number of findings documented.
Document the regions treated and the clinical findings supporting treatment there. Report one service for treatment of three or four regions. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 50 is inappropriate for bilateral treatment. CMS pays an assistant at surgery only when medical necessity is documented; co-surgeons and team surgery are not permitted.
CMS billing rules for 98926
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.69 · 50%
- Practice expense (office) RVU0.65 · 47%
- Malpractice RVU0.04 · 3%
86.1K
Medicare services in 2024 · #606 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.
98926 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$62.07
Use 98927 when OMT treats five or six distinct regions; 98926 is for three or four.
$39.31
98941 describes chiropractic manipulative treatment of three or four spinal regions. 98926 is osteopathic manipulative treatment counted across the broader set of body regions.
Compare 98926 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
Rhode Island →
Office / nonfacility
$47.10
Facility
$30.20
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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 98926 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
12,938
- Code
- 98926
- Physician work
- 0.69
- Practice expense
- 0.65
- Malpractice
- 0.04
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.69 | × 1.019 | 0.7031 |
| Practice expense | 0.65 | × 1.033 | 0.6714 |
| Malpractice | 0.04 | × 0.892 | 0.0357 |
| Total RVUs | 1.4102 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$47.10
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.69 | 1.019 |
| Practice expense | 0.65 | 1.033 |
| Malpractice | 0.04 | 0.892 |
(0.69 × 1.019 + 0.65 × 1.033 + 0.04 × 0.892) × $33.4009 = $47.10
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.69 | 1.019 |
| Practice expense | 0.16 | 1.033 |
| Malpractice | 0.04 | 0.892 |
(0.69 × 1.019 + 0.16 × 1.033 + 0.04 × 0.892) × $33.4009 = $30.20
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.
98926 billing questions
How do I choose between 98925, 98926, and 98927?
Count the distinct body regions treated: 98925 covers one or two, 98926 covers three or four, and 98927 covers five or six.
Do I count each technique or each side as a separate region?
No. Count distinct treated body regions, not the number of manual techniques or sides treated within a region.
Can an E/M service be reported on the same date?
A significant, separately identifiable E/M service may be reported with modifier 25. The documentation should distinguish that evaluation and management work from the OMT service.
Should modifier 50 be appended when both sides are treated?
No. CMS identifies bilateral adjustment as inappropriate for this code; treatment on both sides does not make it a bilateral service.
What documentation supports reporting 98926?
Record the somatic dysfunction findings and identify the three or four distinct regions actually treated.
What is included in the global period?
The 0-day global period includes same-day preoperative and postoperative care.
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.
12,93598015,,Synch audio-only est high 40,I,+,2.60,1.40,,0.57,,0.16,4.16,3.33,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93698016,,Brief comunicaj tech-bsd svc,A,,0.30,0.20,,0.07,,0.02,0.52,0.39,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93798925,,Osteopath manj 1-2 regions,A,,0.45,0.49,,0.11,,0.03,0.97,0.59,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93898926,,Osteopath manj 3-4 regions,A,,0.69,0.65,,0.16,,0.04,1.38,0.89,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,93998927,,Osteopath manj 5-6 regions,A,,0.94,0.82,,0.20,,0.06,1.82,1.20,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94098928,,Osteopath manj 7-8 regions,A,,1.18,0.95,,0.25,,0.07,2.20,1.50,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,94198929,,Osteopath manj 9-10 regions,A,,1.42,1.08,,0.29,,0.07,2.57,1.78,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537