CPT 90381 Fee Schedule
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.
| 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 |
| Common Modifiers | • None • SL • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90381 by major payers:

$486.26

$582.58

$610.48

$595.48
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 90381 | ||||||
United | 90381 | $519.75 | 1477997674 - OLGA KOZLOVA | 471293653 - GANESHA INSTITUTE OF NEUROLOGY AND PSYCHIATRY, S.C. | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90381 | $623.70 | 1326465436 - MUSADDIQ TARIQ | 510064318 - BAYHEALTH MEDICAL CENTER INC | IL | Psychiatry Physician (2084P0800X) |
United | 90381 | $909.55 | 1144267865 - NITIN PATEL | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90381 | $715.71 | 1225211600 - JOHN MILLICHAP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90381 | $766.55 | 1821097627 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90381 | $582.11 | 1922452408 - SONYA MOHAN | 911780160 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90381 | $613.30 | 1578957676 - LAURA VERNON | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90381 | $623.70 | 1154856607 - SHUBHADA REDDY | 756004221 - DALLAS COUNTY HOSPITAL DISTRICT | IL | Psychiatry Physician (2084P0800X) |
United | 90381 | $519.75 | 1598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO | 832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC | FL | Home Health Agency (251E00000X) |
United | 90381 | $1247.40 | 1124003025 - KATHLEEN BOTTUM | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Psychiatry Physician (2084P0800X) |
United | 90381 | $623.70 | 1730214206 - KALYANI GAVINI | 371158318 - (IL) SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90381 | $577.44 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90381 | $623.70 | 1679739395 - BETSY OSTRANDER | 810232122 - BENEFIS HOSPITALS INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90381 | $577.44 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90381 | $519.75 | 1023438009 - MOLLY MCINTOSH | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Home Health Agency (251E00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 90381 vs. Other Immune Globulins, Serum or Recombinant Products Codes
The CPT 90381 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 90381 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 |
|---|---|---|
| 90378 | High | Respiratory Syncytial Virus Immune Globulin (Rsv-Igim) For Intramuscular Use 50 Mg Each |
| 90380 | Moderate | Respiratory Syncytial Virus, Monoclonal Antibody, Seasonal Dose; 0.5 Ml Dosage, For Intramuscular Use |
| 90381 | Moderate | Respiratory Syncytial Virus, Monoclonal Antibody, Seasonal Dose; 1 Ml Dosage, For Intramuscular Use |
| 90384 | Low | Rho(D) Immune Globulin Human Full-Dose For Intramuscular Use |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90381. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90381 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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