CPT 90619 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 • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • SL • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90619 by major payers:
$170.10
$187.10
$195.92
$197.10
| 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 90619 | ||||||
United | 90619 | $185.50 | 1083681654 - DAVID SCHILLING | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90619 | $200.38 | 1508984907 - DAVID BERRIER | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 90619 | $200.22 | 1326465436 - MUSADDIQ TARIQ | 510064318 - BAYHEALTH MEDICAL CENTER INC | MS | Psychiatry Physician (2084P0800X) |
United | 90619 | $200.22 | 1851400485 - GEORGE HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90619 | $80.08 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 90619 | $229.94 | 1760461867 - RITA YADAVA | 363878197 - (IL) RITA YADAVA MDSC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90619 | $197.03 | 1962791343 - JEREMY WONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90619 | $400.45 | 1235186297 - MARY DOBBINS | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90619 | $166.97 | 1962664789 - JAMIE EVANS | 910844563 | NC | Psychiatry Physician (2084P0800X) |
United | 90619 | $191.61 | 1952795254 - MALCOLM VANDREVALA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90619 | $170.19 | 1295728186 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90619 | $246.08 | 1033117007 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90619 | $170.19 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90619 | $246.08 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90619 | $170.19 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE 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 90619 vs. Other Vaccines, Toxoids Codes
The CPT 90619 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 90619 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 |
|---|---|---|
| 90477 | Low | Adenovirus Vaccine Type 7 Live For Oral Use |
| 90581 | Low | Vaccine For Anthrax Injection Beneath The Skin Or Into Muscle |
| 90619 | Low | Meningococcal Conjugate Vaccine, Serogroups A, C, W, Y, Quadrivalent, Tetanus Toxoid Carrier (Menacwy-Tt), For Intramuscular Use |
| 90620 | Moderate | Meningococcal Recombinant Protein And Outer Membrane Vesicle Vaccine Serogroup B (Menb-4c) 2 Dose Schedule For Intramuscular Use (Desc Revised 7/1/2017) Comprehensive Consultation (Eff. 01011935 - Deleted 03312003) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90619. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90619 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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