What do doctors typically charge for Telephone Medical Discussion Provided by Nonphysician Professional?

The nationwide median physician charge for Telephone Medical Discussion Provided by Nonphysician Professional (CPT 98966) is $26.10. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 98966?

The standard insurance baseline reimbursement rate is $12.35. This represents the customary allowable amount established across standard fee schedules.

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CPT 98966Medical Service

Telephone Medical Discussion Provided by Nonphysician Professional

Telephone medical discussion provided by nonphysician professional, 5-10 minutes. Clinical pricing breakdown and utilization metrics across 145 practicing doctors nationwide.

$26.10

Peer Median Charge

Gross billed rate

$12.35

Standard Baseline

Customary allowable

2.1x

National Markup

Charge vs baseline

145

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $26.10. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $12.35 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 98966 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"