98975

Set-up and patient education for remote monitoring of therapy

Medicare pricing data for 2,681 providers across 48 states

🤖AI Overview

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

Set-up and patient education for remote monitoring of therapy (HCPCS code 98975) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $19.46, but hospitals typically charge $50.66 — a 2.6x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$3.89

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $19.46, your out-of-pocket cost would be approximately $3.89. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$19.46
Average Hospital Charge
$50.66
Markup Ratio
2.6x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$50.66
Medicare Allowed$19.46
Medicare Payment$15.04

Hospitals charge 2.6x more than what Medicare allows for this procedure. Medicare actually pays $15.04 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
California$22$552325,470+14.4%
Hawaii$22$55616+10.6%
New York$21$551601,334+9.6%
Massachusetts$21$45121905+8.8%
New Jersey$21$811941,049+8.4%
Connecticut$21$4835463+6.8%
Alaska$21$77592+5.7%
Maryland$20$6149444+2.2%
District of Columbia$20$41483+1.2%
New Hampshire$20$44449+1.0%
Virginia$20$51150990+0.5%
Michigan$19$29684,125+0.2%
Washington$19$431291,446+0.1%
Illinois$19$64106913-0.6%
Colorado$19$3651285-2.2%
Nevada$19$5225359-2.7%
Wyoming$19$311452-3.9%
Florida$19$441612,649-4.0%
Minnesota$19$4045336-4.2%
Pennsylvania$19$54109562-4.5%
Delaware$19$6228540-4.7%
Oregon$18$5059760-5.5%
Utah$18$2512117-7.0%
Arizona$18$42971,457-7.9%
Texas$18$861752,423-8.1%
Missouri$18$4033259-8.3%
Wisconsin$18$6449319-8.9%
North Carolina$18$4066757-8.9%
Idaho$18$46581-9.2%
Georgia$18$4563361-9.4%
Montana$17$35511-10.3%
New Mexico$17$53960-10.7%
South Dakota$17$921440-12.6%
Maine$17$52314-12.6%
Kansas$17$4228179-12.7%
Iowa$17$3927103-12.8%
Nebraska$17$3319129-12.9%
South Carolina$17$6364422-13.1%
Louisiana$17$5737296-13.5%
Kentucky$17$511222-13.7%
Indiana$17$3230390-13.9%
Tennessee$17$3862539-15.2%
West Virginia$17$46515-15.2%
Oklahoma$16$3648606-15.4%
Ohio$16$741229-15.9%
Alabama$16$641638-16.8%
Mississippi$16$61412-17.7%
Arkansas$15$517110-24.3%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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