CPT 98961

Education&Training Self-Mgmt Nonphys 2-4 Pts

CPT 98961 pays $15.70 in a non-facility setting and $15.70 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $13.37 in Arkansas to $18.47 in District of Columbia, a 38% spread.

National non-facility rate

$15.70

Office and other outpatient settings

Facility rate
$15.70

Hospital and ASC settings

Highest state
$18.47

District of Columbia

Lowest state
$13.37

Arkansas · 38% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $15.70
CPT 98961 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $15.70, national facility $15.70.
StateRate compared visuallyNon-facilityFacility
District of Columbia
$18.47$18.47
California
$18.36$18.36
Washington
$17.78$17.78
Hawaii
$17.66$17.66
New Jersey
$17.66$17.66
New York
$17.59$17.59
Massachusetts
$17.54$17.54
Connecticut
$16.95$16.95
Colorado
$16.61$16.61
Alaska
$16.55$16.55
Oregon
$16.43$16.43
Maryland
$16.38$16.38
New Hampshire
$16.29$16.29
Rhode Island
$16.17$16.17
Florida
$16.07$16.07
Minnesota
$15.91$15.91
Puerto Rico
$15.86$15.86
Virgin Islands
$15.86$15.86
Montana
$15.70$15.70
Nevada
$15.66$15.66
Wyoming
$15.61$15.61
North Dakota
$15.50$15.50
Delaware
$15.48$15.48
Illinois
$15.48$15.48
South Dakota
$15.48$15.48
Texas
$15.44$15.44
Pennsylvania
$15.41$15.41
Vermont
$15.38$15.38
Virginia
$15.34$15.34
Arizona
$15.17$15.17
Georgia
$15.06$15.06
Michigan
$14.90$14.90
Maine
$14.89$14.89
Wisconsin
$14.82$14.82
Utah
$14.74$14.74
North Carolina
$14.55$14.55
New Mexico
$14.49$14.49
South Carolina
$14.48$14.48
Missouri
$14.43$14.43
Indiana
$14.41$14.41
Louisiana
$14.38$14.38
Ohio
$14.36$14.36
Nebraska
$14.31$14.31
Idaho
$14.29$14.29
Iowa
$14.19$14.19
Tennessee
$14.15$14.15
Kansas
$14.06$14.06
Oklahoma
$13.98$13.98
Kentucky
$13.96$13.96
West Virginia
$13.83$13.83
Alabama
$13.63$13.63
Mississippi
$13.48$13.48
Arkansas
$13.37$13.37

Billed by 1 specialties

Commercial rates for 98961

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates