CPT 90471 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 • Immunization Administration for Vaccines/Toxoids |
| Common Place of Service | • 11 - Office • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • 59 - Distinct Procedural Service • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90471 by major payers:
$24.51
$21.32
$19.19
$27.75
| 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 90471 | ||||||
United | 90471 | $33.49 | 1568483774 - PETER SINGSON | 331065485 - LEGACY SALMON CREEK HOSPITAL | CA | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $19.15 | 1306893987 - MITCHELL ALVERSON | 636000526 - (AL) EAST ALABAMA MEDICAL CENTER | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $47.65 | 1306054119 - CARRIE COLEMAN | 42697983 - MASS GENERAL BRIGHAM INCORPORATED | MA | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $12.56 | 1326035452 - THOMAS BECKETT | 201200330 - (FL) THOMAS A BECKETT MD LLC | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $45.31 | 1154764504 - KATHERINE LYONS | 262998718 | OR | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $18.37 | 1245236298 - ROBERT PIMENTEL | 260609255 - FLORIDA WOMAN CARE, LLC | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $16.29 | 1407842461 - AMY SOLOMON | 811291017 - (FL) WOMENS HEALTH HOSPITALISTS LLC | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $14.43 | 1942974530 - OB HOSPITALIST GROUP LLC | 273299726 | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $12.81 | 1972590495 - LINDA TEAGLE | 454245667 | CA | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $18.32 | 1497963748 - ANITRA BROWN | 591671640 - (FL) FLORIDA COMMUNITY HEALTH CENTERS INC | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $16.29 | 1417110610 - RYAN NEUHAUS | 593443182 - WOMENS CARE FLORIDA, LLP | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $56.99 | 1295998490 - QUAN DAU | 910214500 - THE EVERETT CLINIC, PLLC | WA | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $15.73 | 1013012541 - MARIE-CARMELLE LIBURD | 591417397 - (FL) BORINQUEN HEALTH CARE CENTER INC | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $18.63 | 1093820151 - ROBERT RAINER | 330645967 - EPIC MANAGEMENT, L.P. & BEAVER MEDICAL GROUP, L.P. | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 90471 | $18.37 | 1205803111 - AARON SUDBURY | 452561360 | FL | Obstetrics & Gynecology Physician (207V00000X) |
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 90471 vs. Other Immunization Administration for Vaccines/Toxoids Codes
The CPT 90471 code is part of the Medicine Services and Procedures services used for Immunization Administration for Vaccines/Toxoids. 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 90471 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 |
|---|---|---|
| 90460 | Low | Immunization Administration Through 18 Years Of Age Via Any Route Of Administration, With Counseling By Physician Or Other Qualified Health Care Professional; First Or Only Component Of Each Vaccine Or Toxoid Administered |
| 90461 | Low | Immunization Administration Through 18 Years Of Age Via Any Route Of Administration, With Counseling By Physician Or Other Qualified Health Care Professional; Each Additional Vaccine Or Toxoid Component Administered (List Separately In Addition To Code For Primary |
| 90471 | Low | Immunization Administration (Includes Percutaneous Intradermal Subcutaneous Intramuscular And Jet Injections); One Vaccine (Single Or Combination Vaccine/Toxoid) |
| 90472 | Low | Immunization Administration (Includes Percutaneous Intradermal Subcutaneous Intramuscular And Jet Injections); Each Additional Vaccine (Single Or Combination Vaccine/Toxoid) (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90471. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90471 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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