CPT 90647 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 50 - Federally Qualified Health Center |
| Common Modifiers | None SL EP - Residential facility to Physician's office |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90647 |
National average reimbursement for CPT 90647 by major payers:
$33.48
$34.02
$35.51
$34.06
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90647 | $32.68 | 1285834440 - LARON PHILLIPS | 842494027 - BRIGHTSIDE MEDICAL | MI | Psychiatry Physician (2084P0800X) |
United | 90647 | $36.08 | 1578531950 - DAVID RITACCO | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90647 | $29.70 | 1043522899 - SHARAD KOIRALA | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90647 | $30.57 | 1225211600 - JOHN MILLICHAP | 753186720 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90647 | $36.54 | 1881012235 - LAUREN PREST | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 90647 | $36.70 | 1699781310 - GHASSAN ALDURRA | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90647 | $30.57 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 90647 | $30.57 | 1508194887 - AYISHA JAMEEL | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IL | Psychiatry Physician (2084P0800X) |
United | 90647 | $33.97 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | NC | Psychiatry Physician (2084P0800X) |
United | 90647 | $31.05 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90647 | $36.70 | 1619264413 - NITIKA PANT | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90647 | $36.70 | 1962507954 - ROSELIN ARUNACHALAM | 371140016 - CARLE HEALTH CARE INCORPORATED | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90647 | $30.57 | 1215025309 - DEBORAH GARRELTS-DAOUD | 237076080 - (IL) CRUSADERS CENTRAL CLINIC ASSOCIATION | IA | Psychiatry Physician (2084P0800X) |
United | 90647 | $33.97 | 1336431667 - SURAYA KAWADRY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90647 | $50.38 | 1790936540 - SRISHTI NANGIA | 131623978 | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
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 90647 vs. Other Medicine Services and Procedures Codes
The CPT 90647 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 90647 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 |
|---|---|---|
| 90633-CPT | Low | Hepatitis A Vaccine Solution, A Solution Of Hepatitis A Prepared For A Vaccination. The Vaccine May Be Given In A Series Of Two To Three Shots. |
| 90634-CPT | Low | Hepatitis A Vaccine Solution, A Solution Of Hepatitis A Prepared For A Vaccination. The Vaccine May Be Given In A Series Of Two To Three Shots. |
| 90636-CPT | Low | Hepatitis Ab Vaccine Solution, Combined Hepatitis A And B Vaccine Solution For Adult Injection (Shot). The Vaccine Provides Protection Against Hepatitis A And B Infections. |
| 90647-CPT | Low | Hemophilus Influenza B Vaccine, Hib (Haemophilus Influenza B) Vaccine Solution. Hib Is A Bacteria That Can Cause Serious Infections (Such As Pneumonia Or Meningitis) For Infants And Children. The Vaccine Is Given As A Series Of Three To Four Shots. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90647. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90647 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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