98980

Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month

Medicare pricing data for 2,235 providers across 44 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

Remote therapeutic monitoring treatment management services by physician or other qualified health care professional, first 20 minutes per calendar month (HCPCS code 98980) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $50.76, but hospitals typically charge $94.31 — a 1.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$10.15

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $50.76, your out-of-pocket cost would be approximately $10.15. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$50.76
Average Hospital Charge
$94.31
Markup Ratio
1.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$94.31
Medicare Allowed$50.76
Medicare Payment$39.31

Hospitals charge 1.9x more than what Medicare allows for this procedure. Medicare actually pays $39.31 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Alaska$61$2364617+19.5%
Michigan$54$735541,001+6.7%
New York$54$94971,714+5.9%
Massachusetts$53$10253623+3.6%
New Hampshire$53$109337+3.6%
New Jersey$52$1512942,971+2.1%
Connecticut$52$73301,187+2.1%
California$51$1071786,185+0.1%
Oregon$50$198431,880-1.3%
Illinois$50$97953,138-1.6%
Washington$49$1021323,413-3.6%
Minnesota$49$80665-3.7%
Florida$49$671029,413-4.3%
Virginia$48$1031682,360-5.2%
Colorado$48$7151672-5.2%
Pennsylvania$48$1291201,449-5.6%
Maryland$47$188401,072-6.6%
District of Columbia$47$104390-6.6%
Nevada$47$98271,816-6.7%
Missouri$47$6127610-6.7%
Delaware$47$143272,291-6.8%
Idaho$47$1014124-8.2%
Utah$47$535340-8.3%
Louisiana$46$10016219-9.2%
Wisconsin$46$14424346-9.2%
South Dakota$46$82724-9.3%
Iowa$46$59646-10.1%
Wyoming$46$781180-10.2%
Georgia$46$102501,037-10.3%
Nebraska$45$506136-10.5%
North Carolina$45$9346740-10.7%
Kansas$45$821396-11.5%
Texas$45$1531585,262-11.6%
South Carolina$45$108591,267-11.9%
Arkansas$45$7619300-12.1%
Arizona$44$108502,196-13.0%
Alabama$44$1041041-13.4%
Rhode Island$44$551355-13.5%
Tennessee$44$8255752-13.8%
Indiana$44$6532297-14.1%
Oklahoma$42$102471,480-16.7%
Montana$41$80230-18.4%
Ohio$40$931544-21.0%
West Virginia$40$58442-21.3%

⚠️ 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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💊 Need post-procedure medications? Check costs on OpenPrescriber