Telephone, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes
Medicare pricing data for 5,647 providers across 44 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, internet, or electronic health record assessment and management with written report by consulting physician, at least 5 minutes (HCPCS code 99451) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $35.13, but hospitals typically charge $87.30 — a 2.5x 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 $35.13, your out-of-pocket cost would be approximately $7.03. 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 2.5x more than what Medicare allows for this procedure. Medicare actually pays $26.80 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $47 | $121 | 5 | 37 | +33.0% |
| California | $39 | $130 | 567 | 8,886 | +9.6% |
| New York | $38 | $129 | 277 | 2,404 | +7.7% |
| New Jersey | $37 | $114 | 39 | 241 | +6.5% |
| Massachusetts | $37 | $94 | 76 | 930 | +4.7% |
| Washington | $36 | $89 | 268 | 4,061 | +3.7% |
| Maryland | $36 | $111 | 31 | 375 | +3.3% |
| Rhode Island | $36 | $97 | 3 | 24 | +3.2% |
| Connecticut | $36 | $101 | 43 | 178 | +3.1% |
| Delaware | $35 | $97 | 17 | 51 | +0.9% |
| Oregon | $35 | $72 | 179 | 3,646 | +0.6% |
| Montana | $35 | $76 | 8 | 58 | +0.2% |
| Michigan | $35 | $109 | 227 | 2,748 | +0.2% |
| Illinois | $35 | $136 | 51 | 320 | -0.2% |
| Georgia | $35 | $109 | 29 | 388 | -0.3% |
| New Hampshire | $35 | $116 | 10 | 62 | -0.3% |
| Florida | $35 | $117 | 211 | 1,382 | -0.7% |
| Oklahoma | $35 | $101 | 15 | 255 | -0.8% |
| Colorado | $35 | $58 | 136 | 3,891 | -1.5% |
| Virginia | $35 | $75 | 246 | 2,931 | -1.6% |
| West Virginia | $35 | $98 | 10 | 41 | -1.8% |
| Nevada | $34 | $35 | 23 | 12,591 | -2.0% |
| Vermont | $34 | $110 | 45 | 448 | -2.2% |
| Utah | $34 | $107 | 83 | 332 | -2.4% |
| North Carolina | $34 | $115 | 174 | 1,249 | -2.6% |
| Minnesota | $34 | $109 | 1,123 | 6,861 | -2.6% |
| Ohio | $34 | $135 | 217 | 1,098 | -2.8% |
| Texas | $34 | $111 | 243 | 4,543 | -2.9% |
| Wisconsin | $34 | $125 | 97 | 568 | -2.9% |
| New Mexico | $34 | $66 | 41 | 260 | -3.3% |
| South Carolina | $34 | $137 | 3 | 16 | -3.3% |
| Alabama | $34 | $60 | 59 | 570 | -3.5% |
| Pennsylvania | $34 | $88 | 456 | 2,731 | -3.7% |
| Maine | $34 | $88 | 24 | 142 | -3.9% |
| Arizona | $34 | $65 | 157 | 3,126 | -4.1% |
| Missouri | $34 | $101 | 49 | 1,061 | -4.2% |
| Louisiana | $33 | $74 | 73 | 494 | -4.8% |
| Indiana | $33 | $48 | 157 | 1,774 | -4.9% |
| Iowa | $33 | $139 | 34 | 198 | -5.0% |
| Nebraska | $33 | $91 | 35 | 137 | -5.1% |
| Idaho | $33 | $36 | 11 | 521 | -5.9% |
| Tennessee | $33 | $120 | 34 | 362 | -6.9% |
| Arkansas | $31 | $68 | 4 | 11 | -12.6% |
| Mississippi | $29 | $73 | 27 | 188 | -17.0% |
⚠️ 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