CPT 90621 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 | Low |
National average reimbursement for CPT 90621 by major payers:
$195.30
$212.85
$218.29
$223.07
| 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 90621 | ||||||
United | 90621 | $262.00 | 1285712851 - MOHAMMAD IKRAMUDDIN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $224.50 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $224.50 | 1508192048 - DIANA SIECIECHOWICZ | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $211.38 | 1679515951 - EUGENE SCHNITZLER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $272.45 | 1215597554 - MATTEO RESPINO | 351747218 - INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC | IN | Psychiatry Physician (2084P0800X) |
United | 90621 | $272.45 | 1528695681 - MAYA CLOYD | 351913875 - INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS | IL | Psychiatry Physician (2084P0800X) |
United | 90621 | $222.69 | 1255478004 - CHRISTOPHER RAIO | 208243412 - SAMARITAN EMERGENCY MEDICAL SERVICES PC | NY | Emergency Medicine Physician (207P00000X) |
United | 90621 | $218.80 | 1225211600 - JOHN MILLICHAP | 383852646 - OSF MULTI-SPECIALTY GROUP | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $214.99 | 1013538636 - OYOYO SAWYER | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 90621 | $211.38 | 1679968697 - JEREMIAH BREWER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 90621 | $211.38 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 90621 | $262.00 | 1760461867 - RITA YADAVA | 363878197 - (IL) RITA YADAVA MDSC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90621 | $250.97 | 1629021787 - KIMBALL LADIEN | 362743287 - TCA HEALTH INC NFP | IL | Psychiatry Physician (2084P0800X) |
United | 90621 | $214.99 | 1881012235 - LAUREN PREST | 910843135 | UT | Psychiatry Physician (2084P0800X) |
United | 90621 | $280.42 | 1972501252 - 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 90621 vs. Other Vaccines, Toxoids Codes
The CPT 90621 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 90621 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 |
|---|---|---|
| 90584-CPT | Low | Dengue Vaccine, Quadrivalent, Live, 2 Dose Schedule, For Subcutaneous Use |
| 90587-CPT | Low | Dengue Vaccine, Quadrivalent, Live, 3 Dose Schedule, For Subcutaneous Use |
| 90611-CPT | Moderate | Smallpox And Monkeypox Vaccine, Attenuated Vaccinia Virus, Live, Non-Replicating, Preservative Free, 0.5 Ml Dosage, Suspension, For Subcutaneous Injection |
| 90621-CPT | Low | Meningococcal Recombinant Lipoprotein Vaccine Serogroup B (Menb-Fhbp) 2 Or 3 Dose Schedule For Intramuscular Use (Desc Revised 7/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90621. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90621 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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