# CPT 98972: Qnhp Ol Digital Assmt&mgmt Est Pt <7 D 21+ Min

Medicare CPT 98972 pays $34.40 in a non-facility setting and $29.06 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $32.46 in Arkansas to $46.15 in Alaska, a 42% spread.

Web page: https://www.med-reveal.com/rates/98972-cpt-fee-schedule
Section: Medical and Therapeutic Services
Billed by: Clinical Neuropsychologist, Counselor, Marriage & Family Therapist, Methadone Clinic, Psychoanalyst, Social Worker

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $34.40 |
| National facility | $29.06 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| Alaska | $46.15 | $40.46 |
| District of Columbia | $37.60 | $31.31 |
| New York | $37.05 | $31.09 |
| New Jersey | $36.97 | $30.96 |
| California | $36.67 | $30.35 |
| Washington | $36.36 | $30.28 |
| Massachusetts | $36.19 | $30.18 |
| Connecticut | $35.87 | $30.12 |
| Hawaii | $35.40 | $29.32 |
| Florida | $35.39 | $30.02 |
| Maryland | $35.23 | $29.65 |
| Colorado | $35.12 | $29.44 |
| Rhode Island | $35.07 | $29.55 |
| Illinois | $35.05 | $29.88 |
| Oregon | $34.86 | $29.24 |
| New Hampshire | $34.70 | $29.14 |
| Puerto Rico | $34.50 | $29.10 |
| Virgin Islands | $34.50 | $29.10 |
| Pennsylvania | $34.47 | $29.23 |
| Montana | $34.40 | $29.06 |
| Texas | $34.30 | $29.04 |
| Delaware | $34.29 | $29.01 |
| Nevada | $34.25 | $28.90 |
| Michigan | $34.18 | $29.16 |
| Georgia | $34.16 | $29.06 |
| Wyoming | $34.14 | $28.80 |
| Minnesota | $34.00 | $28.50 |
| Arizona | $33.94 | $28.76 |
| Virginia | $33.93 | $28.68 |
| North Dakota | $33.81 | $28.46 |
| Vermont | $33.80 | $28.51 |
| New Mexico | $33.74 | $28.84 |
| South Dakota | $33.74 | $28.39 |
| Utah | $33.68 | $28.66 |
| Maine | $33.57 | $28.46 |
| Louisiana | $33.55 | $28.67 |
| Missouri | $33.54 | $28.63 |
| Ohio | $33.51 | $28.63 |
| West Virginia | $33.48 | $28.83 |
| South Carolina | $33.47 | $28.53 |
| North Carolina | $33.35 | $28.36 |
| Wisconsin | $33.27 | $28.15 |
| Kentucky | $33.17 | $28.42 |
| Indiana | $33.13 | $28.18 |
| Oklahoma | $33.07 | $28.30 |
| Idaho | $33.05 | $28.13 |
| Tennessee | $33.00 | $28.14 |
| Nebraska | $32.98 | $28.05 |
| Iowa | $32.92 | $28.03 |
| Kansas | $32.91 | $28.08 |
| Mississippi | $32.70 | $28.10 |
| Alabama | $32.67 | $28.00 |
| Arkansas | $32.46 | $27.87 |

## Related codes

- 90632: Hepa Vaccine Adult Dose for Intramuscular Use — https://www.med-reveal.com/rates/90632-cpt-fee-schedule
- 90633: Hepa Vaccine 2 Dose Schedule Ped/adolesc Im Use — https://www.med-reveal.com/rates/90633-cpt-fee-schedule
- 90647: Hib Prp-omp Vaccine 3 Dose Schedule Im Use — https://www.med-reveal.com/rates/90647-cpt-fee-schedule
- 90648: Hib Prp-t Vaccine 4 Dose Schedule Im Use — https://www.med-reveal.com/rates/90648-cpt-fee-schedule
- 90680: Rv5 Vaccine 3 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90680-cpt-fee-schedule
- 90681: Rv1 Vaccine 2 Dose Schedule Live for Oral Use — https://www.med-reveal.com/rates/90681-cpt-fee-schedule
- 90698: Dtap-ipv/hib Vaccine for Intramuscular Use — https://www.med-reveal.com/rates/90698-cpt-fee-schedule
- 90710: Measles Mumps Rubella Varicella Vacc Live Subq — https://www.med-reveal.com/rates/90710-cpt-fee-schedule

Commercial negotiated rates for 98972 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules