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See a sample rate comparisonCPT 90396 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
Solution To Prevent Chickenpox, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Infection By The Virus That Causes Chickenpox. This Solution Is Given By Shot.
| 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 | JZ - Zero drug amount discarded/not administered to any patient SL |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 90396 |
| Medicaid Fee Schedule | $1,402.88 median of the 8 states in the free preview · View Medicaid rates for 90396 |
National average reimbursement for CPT 90396 by major payers:
$1,937.99
$2,482.88
$2,346.72
$2,378.11
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CPT 90396
5 of 25 sample ratesHigher to lower in this preview
P. Daniel Le Grange
$4,767.50Published rateNishant Shah
Advocate Health And Hospitals Corporation
$2,946.56Published rateMusaddiq Tariq
Loyola University Medical Center
$2,497.58Published rateOday Alsarraf
Swedishamerican Hospital
$2,248.05Published rateChristopher Raio
St Joseph Hospital
$2,023.25Published rate
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See a sample payer proposalCPT 90396 vs. Other Immune Globulins, Serum or Recombinant Products Codes
The CPT 90396 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 90396 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 |
|---|---|---|
| 90284-CPT | Low | Human Immune Globulin, Human Immune Globulin Is Derived From Blood Products And Is Typically Given As A Shot Through An Iv Or Under The Skin With Fluids. |
| 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. |
| 90380-CPT | Moderate | Rsv Immune Globulin, Respiratory Syncytial Virus (Rsv) Immune Globulin. Rsv Is An Infection That Causes Colds Coughs And Sometimes Pneumonia In Children And Infants. |
| 90396-CPT | High | Solution To Prevent Chickenpox, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Infection By The Virus That Causes Chickenpox. This Solution Is Given By Shot. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90396. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90396 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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