Telephone medical discussion provided by nonphysician professional, 11-20 minutes
Medicare pricing data for 2,269 providers across 47 states
This is a specialized procedure with relatively few Medicare claims. Pricing data may be less reliable due to smaller sample sizes. 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, 11-20 minutes (HCPCS code 98967) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $21.31, but hospitals typically charge $72.34 — a 3.4x 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 $21.31, your out-of-pocket cost would be approximately $4.26. 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 3.4x more than what Medicare allows for this procedure. Medicare actually pays $14.94 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $31 | $110 | 20 | 47 | +46.2% |
| District of Columbia | $26 | $72 | 27 | 100 | +23.0% |
| Delaware | $24 | $35 | 5 | 130 | +10.5% |
| New Jersey | $23 | $102 | 37 | 232 | +9.2% |
| Colorado | $23 | $55 | 106 | 240 | +8.2% |
| Hawaii | $23 | $52 | 26 | 107 | +7.3% |
| California | $23 | $70 | 300 | 2,038 | +7.1% |
| Idaho | $22 | $45 | 8 | 56 | +3.8% |
| Maryland | $22 | $94 | 101 | 412 | +3.8% |
| Alabama | $22 | $84 | 11 | 42 | +3.7% |
| Florida | $22 | $71 | 144 | 470 | +3.6% |
| Mississippi | $22 | $50 | 7 | 17 | +3.5% |
| New York | $22 | $94 | 91 | 416 | +2.5% |
| Georgia | $22 | $60 | 22 | 77 | +2.4% |
| Virginia | $22 | $65 | 111 | 375 | +2.4% |
| Tennessee | $22 | $87 | 17 | 26 | +1.5% |
| Massachusetts | $22 | $64 | 40 | 167 | +0.9% |
| Washington | $21 | $78 | 85 | 203 | +0.2% |
| North Carolina | $21 | $68 | 67 | 200 | +0.1% |
| South Carolina | $21 | $51 | 63 | 151 | +0.1% |
| Arizona | $21 | $52 | 37 | 147 | -0.5% |
| Arkansas | $21 | $191 | 9 | 179 | -1.2% |
| Texas | $21 | $68 | 104 | 621 | -1.4% |
| Utah | $21 | $46 | 48 | 56 | -1.6% |
| Montana | $21 | $74 | 18 | 69 | -1.8% |
| Oklahoma | $21 | $75 | 22 | 52 | -1.9% |
| New Hampshire | $21 | $42 | 7 | 14 | -2.3% |
| Wyoming | $21 | $153 | 6 | 13 | -2.8% |
| New Mexico | $21 | $101 | 14 | 55 | -3.2% |
| Nebraska | $21 | $66 | 10 | 12 | -3.8% |
| West Virginia | $20 | $63 | 4 | 12 | -4.4% |
| Louisiana | $20 | $53 | 8 | 34 | -5.8% |
| Ohio | $20 | $69 | 102 | 237 | -6.1% |
| Wisconsin | $20 | $112 | 21 | 40 | -6.6% |
| Oregon | $20 | $74 | 77 | 188 | -6.9% |
| Illinois | $20 | $79 | 60 | 389 | -7.1% |
| Minnesota | $20 | $92 | 63 | 158 | -7.7% |
| Vermont | $19 | $42 | 8 | 67 | -8.9% |
| Connecticut | $19 | $61 | 73 | 688 | -8.9% |
| Pennsylvania | $19 | $67 | 96 | 518 | -9.2% |
| Kentucky | $19 | $46 | 12 | 30 | -9.3% |
| Nevada | $19 | $55 | 20 | 64 | -9.7% |
| Indiana | $19 | $71 | 14 | 44 | -10.3% |
| Maine | $19 | $69 | 12 | 17 | -12.0% |
| Missouri | $18 | $92 | 11 | 66 | -16.6% |
| Iowa | $18 | $62 | 6 | 45 | -17.1% |
| Michigan | $17 | $48 | 103 | 354 | -19.6% |
⚠️ 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