Telephone medical discussion provided by nonphysician professional, 21-30 minutes
Medicare pricing data for 2,217 providers across 45 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, 21-30 minutes (HCPCS code 98968) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $29.56, but hospitals typically charge $100.27 — 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 $29.56, your out-of-pocket cost would be approximately $5.91. 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 $21.07 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $43 | $204 | 16 | 33 | +44.5% |
| District of Columbia | $37 | $103 | 25 | 154 | +23.7% |
| Hawaii | $33 | $71 | 23 | 214 | +11.6% |
| New Jersey | $32 | $144 | 39 | 193 | +8.2% |
| Colorado | $32 | $88 | 91 | 189 | +7.3% |
| Mississippi | $32 | $47 | 4 | 337 | +6.7% |
| California | $32 | $113 | 471 | 3,040 | +6.6% |
| Maryland | $31 | $103 | 102 | 486 | +6.0% |
| Florida | $31 | $87 | 90 | 368 | +5.0% |
| Pennsylvania | $31 | $99 | 72 | 350 | +3.8% |
| Idaho | $31 | $59 | 7 | 77 | +3.3% |
| Texas | $30 | $100 | 95 | 570 | +2.9% |
| Georgia | $30 | $89 | 29 | 142 | +2.8% |
| Virginia | $30 | $87 | 78 | 240 | +2.3% |
| Washington | $30 | $112 | 84 | 226 | +0.5% |
| Massachusetts | $30 | $107 | 43 | 290 | +0.2% |
| Arizona | $29 | $91 | 37 | 99 | -0.9% |
| New Hampshire | $29 | $71 | 11 | 24 | -1.0% |
| Oklahoma | $29 | $113 | 15 | 27 | -1.9% |
| New Mexico | $29 | $109 | 11 | 145 | -2.4% |
| Ohio | $28 | $114 | 84 | 299 | -3.7% |
| Louisiana | $28 | $82 | 6 | 19 | -3.9% |
| Nevada | $28 | $47 | 16 | 628 | -4.9% |
| Alabama | $28 | $94 | 9 | 54 | -5.1% |
| New York | $28 | $117 | 88 | 868 | -5.6% |
| North Carolina | $28 | $93 | 74 | 327 | -5.8% |
| Tennessee | $28 | $108 | 19 | 35 | -5.8% |
| Montana | $28 | $111 | 20 | 109 | -6.7% |
| Illinois | $27 | $99 | 64 | 478 | -7.2% |
| Utah | $27 | $76 | 23 | 51 | -7.5% |
| South Carolina | $27 | $125 | 48 | 133 | -7.6% |
| Arkansas | $27 | $277 | 4 | 33 | -8.3% |
| Connecticut | $27 | $83 | 63 | 675 | -9.5% |
| Wisconsin | $27 | $203 | 21 | 38 | -9.6% |
| Oregon | $27 | $110 | 81 | 292 | -10.4% |
| Nebraska | $26 | $96 | 11 | 65 | -11.0% |
| Rhode Island | $26 | $69 | 10 | 37 | -11.2% |
| Minnesota | $26 | $143 | 65 | 209 | -11.4% |
| Michigan | $26 | $70 | 57 | 268 | -12.9% |
| Kentucky | $26 | $66 | 12 | 35 | -13.7% |
| Maine | $25 | $109 | 9 | 15 | -15.0% |
| Iowa | $25 | $79 | 15 | 95 | -15.7% |
| Missouri | $25 | $123 | 13 | 66 | -16.2% |
| Indiana | $25 | $107 | 27 | 218 | -16.8% |
| Vermont | $24 | $107 | 6 | 54 | -20.3% |
⚠️ 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