CPT 90585 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 | Vaccines, Toxoids Medicine Services and Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility 50 - Federally Qualified Health Center |
| Common Modifiers | None UD 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90585 |
National average reimbursement for CPT 90585 by major payers:
$168.76
$189.56
$179.59
$184.86
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90585 | $188.05 | 1407807746 - SYED KHAN | 320552496 | IN | Psychiatry Physician (2084P0800X) |
United | 90585 | $193.03 | 1609239243 - MEGAN GINSBURG | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90585 | $200.46 | 1578957676 - LAURA VERNON | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90585 | $182.58 | 1225211600 - JOHN MILLICHAP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90585 | $304.30 | 1780830794 - KARA DRISCOLL | 232919472 - UPMC | IL | Psychiatry Physician (2084P0800X) |
United | 90585 | $181.47 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 90585 | $195.36 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | CO | Psychiatry Physician (2084P0800X) |
United | 90585 | $188.74 | 1679968697 - JEREMIAH BREWER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 90585 | $179.69 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | IN | Psychiatry Physician (2084P0800X) |
United | 90585 | $182.58 | 1285712851 - MOHAMMAD IKRAMUDDIN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90585 | $227.11 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90585 | $188.47 | 1144370990 - ROLANDO HENRIQUEZ | 363950044 - PROGRESSIVE MEDICAL CENTER, S.C. | IL | Internal Medicine Physician (207R00000X) |
United | 90585 | $163.35 | 1679729875 - KAIZ ASIF | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90585 | $182.94 | 1144203753 - HAIDAR KABBANI | 911780160 | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90585 | $224.25 | 1083815435 - HUGO SOLARI | 320115907 - (IL) ESPERANZA HEALTH CENTERS | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 90585 vs. Other Medicine Services and Procedures Codes
The CPT 90585 code is part of the Vaccines, Toxoids services used for Medicine Services and Procedures. 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 90585 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 |
|---|---|---|
| 90476-CPT | Low | Oral Vaccine For Adenovirus, Vaccine Solution Given By Mouth To Prevent Illnesses Caused By Adenoviruses. Adenoviruses Commonly Cause Lung Illnesses Diarrhea And Eye Infections. |
| 90477-CPT | Low | Oral Vaccine For Adenovirus, Vaccine Solution Given By Mouth To Prevent Illnesses Caused By Adenoviruses. Adenoviruses Commonly Cause Lung Illnesses Diarrhea And Eye Infections. |
| 90585-CPT | Low | Bacillus Calmette-Guerin Vacc (Bcg) For Tuberculosis Live, Bacillus Calmette-Guerin Vaccine (Bcg) For Tuberculosis Live For Per |
| 90626-CPT | Moderate | Tick-Borne Enceph Vacc Inactivated 0.25ml Im Use, Tick-Borne Encephalitis Virus Vaccine Inactivated; 0.25 Ml Dosage 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 90585. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90585 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 90585) and we'll show you how you compare in 15 minutes or less.