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See a sample rate comparisonCPT 90296 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Diphtheria Immunity Solution, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Diphtheria Infection Which Affects The Nose And The Throat And Can Lead To Difficulty Breathing.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Immune Globulins, Serum or Recombinant Products |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90296 |
| Medicaid Fee Schedule | $30.355 median of the 2 states in the free preview · View Medicaid rates for 90296 |
National average reimbursement for CPT 90296 by major payers:
$32.90
$204.96
$363.85
$295.39
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CPT 90296
5 of 25 sample ratesHigher to lower in this preview
Sutter Tracy Community Hospital
Sutter Valley Hospitals
$9,442.46Published rateSutter Valley Hospitals, Sutter Solano Medical Center
Sutter Valley Hospitals
$9,442.46Published rateSutter Bay Hospitals, Mills-Peninsula Medical Center
Sutter Bay Hospitals
$8,959.65Published rateAll Ways Homecare Inc
$40.00Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$34.30Published rate
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See a sample payer proposalCPT 90296 vs. Other Immune Globulins, Serum or Recombinant Products Codes
The CPT 90296 code is part of the Medicine Services and Procedures services used for Immune Globulins, Serum or Recombinant Products. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 90296 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 90287-CPT | Low | Botulism Treatment, Treatment For Botulism An Illness Caused By Clostridium Botulinum Bacteria. |
| 90296-CPT | Low | Diphtheria Immunity Solution, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Diphtheria Infection Which Affects The Nose And The Throat And Can Lead To Difficulty Breathing. |
| 90371-CPT | Low | Hepatitis B Immunity Solution, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Infection By The Hepatitis B Virus Which Causes A Serious Liver Infection. |
| 90393-CPT | Low | Smallpox Immunity Solution, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Infection By The Virus That Causes Smallpox. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90296. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90296 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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