Telephone medical discussion provided by nonphysician professional, 5-10 minutes
Medicare pricing data for 1,778 providers across 39 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Telephone medical discussion provided by nonphysician professional, 5-10 minutes (HCPCS code 98966) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $11.86, but hospitals typically charge $38.94 — a 3.3x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $11.86, your out-of-pocket cost would be approximately $2.37. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.3x more than what Medicare allows for this procedure. Medicare actually pays $8.43 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| District of Columbia | $14 | $41 | 14 | 53 | +19.6% |
| New Jersey | $14 | $45 | 39 | 514 | +14.4% |
| Colorado | $13 | $31 | 62 | 123 | +8.5% |
| West Virginia | $13 | $32 | 3 | 18 | +8.1% |
| California | $13 | $51 | 208 | 1,334 | +6.5% |
| Hawaii | $13 | $32 | 30 | 98 | +6.2% |
| South Carolina | $12 | $62 | 32 | 216 | +5.1% |
| Florida | $12 | $35 | 168 | 1,669 | +4.0% |
| New Mexico | $12 | $64 | 12 | 176 | +3.1% |
| North Carolina | $12 | $25 | 86 | 458 | +2.5% |
| Delaware | $12 | $34 | 4 | 52 | +1.6% |
| Georgia | $12 | $39 | 22 | 36 | +1.4% |
| Alabama | $12 | $30 | 61 | 466 | +1.1% |
| Maryland | $12 | $66 | 61 | 367 | +0.7% |
| Ohio | $12 | $37 | 58 | 193 | -0.2% |
| Tennessee | $12 | $53 | 33 | 56 | -0.6% |
| Texas | $12 | $31 | 85 | 854 | -0.8% |
| Utah | $12 | $24 | 24 | 48 | -0.9% |
| New York | $12 | $49 | 82 | 371 | -1.5% |
| Wisconsin | $12 | $55 | 18 | 32 | -1.5% |
| Connecticut | $12 | $50 | 27 | 129 | -1.6% |
| Illinois | $12 | $40 | 29 | 184 | -2.0% |
| Montana | $12 | $50 | 9 | 17 | -2.1% |
| Virginia | $12 | $32 | 55 | 143 | -2.3% |
| Massachusetts | $12 | $41 | 28 | 86 | -2.4% |
| Arizona | $12 | $27 | 26 | 238 | -3.0% |
| Pennsylvania | $11 | $37 | 56 | 224 | -3.3% |
| Arkansas | $11 | $41 | 11 | 183 | -4.5% |
| Oklahoma | $11 | $39 | 14 | 67 | -4.8% |
| Kansas | $11 | $40 | 5 | 15 | -6.1% |
| Washington | $11 | $28 | 57 | 360 | -6.3% |
| Nevada | $11 | $27 | 22 | 122 | -6.5% |
| Louisiana | $11 | $29 | 15 | 47 | -7.2% |
| Oregon | $11 | $42 | 57 | 142 | -9.8% |
| Indiana | $10 | $47 | 14 | 104 | -11.7% |
| Minnesota | $10 | $53 | 34 | 78 | -13.5% |
| Missouri | $10 | $55 | 14 | 63 | -14.8% |
| Mississippi | $10 | $38 | 5 | 11 | -18.6% |
| Michigan | $9 | $20 | 160 | 597 | -27.7% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber