CPT 90584 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 • Vaccines, Toxoids |
| Common Place of Service | • 11 - Office |
| Common Modifiers | • None |
| Complexity Level | Low |
National average reimbursement for CPT 90584 by major payers:
$71.28
$107.13
$N/A
$99,999.77
| 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 90584 | ||||||
United | 90584 | $124.80 | 1508984907 - DAVID BERRIER | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 90584 | $137.28 | 1386969079 - ADAM WALLACE | 363907436 - ROCKFORD HEALTH PHYSICIANS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90584 | $124.80 | 1639111248 - ROBERT EGEL | 363155454 - (IL) ROBERT T EGEL M D S C | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90584 | $153.39 | 1235122029 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90584 | $122.73 | 1558354357 - MARIA FISFALEN | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 90584 | $115.55 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | VA | Psychiatry Physician (2084P0800X) |
United | 90584 | $182.02 | 1972543080 - HOSSAM ABDELSALAM | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90584 | $115.15 | 1992905335 - PARAG MERAI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90584 | $104.01 | 1730263617 - MARK ALTER | 811324691 | MT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90584 | $227.19 | 1871912683 - LAUREN SCHUMACHER | 943281673 | CA | Psychiatry Physician (2084P0800X) |
United | 90584 | $143.22 | 1164786836 - REBECCA GILFILLAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90584 | $114.41 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | VA | Psychiatry Physician (2084P0800X) |
United | 90584 | $115.55 | 1407023674 - THEODOTE PONTIKES | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90584 | $115.15 | 1073042727 - SHAWN KACKER | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90584 | $117.52 | 1093164238 - MARTIN GREENWALD | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
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 90584 vs. Other Vaccines, Toxoids Codes
The CPT 90584 code is part of the Medicine Services and Procedures services used 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 90584 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 |
|---|---|---|
| 90581-CPT | Low | Vaccine For Anthrax Injection Beneath The Skin Or Into Muscle |
| 90584-CPT | Low | Dengue Vaccine, Quadrivalent, Live, 2 Dose Schedule, For Subcutaneous Use |
| 90585-CPT | Low | Bacillus Calmette-Guerin Vaccine For Tuberculosis Live For Percutaneous Use |
| 90619-CPT | Low | Meningococcal Conjugate Vaccine, Serogroups A, C, W, Y, Quadrivalent, Tetanus Toxoid Carrier (Menacwy-Tt), 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 90584. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90584 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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