CPT 90661 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 • 60 - Mass Immunization Center |
| Common Modifiers | • None • SL • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90661 by major payers:
$35.51
$36.31
$41.22
$47.12
| 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 90661 | ||||||
United | 90661 | $38.29 | 1710244991 - ALBA PERGJIKA | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90661 | $47.68 | 1013915149 - BAYCARE HOME CARE, INC., DBA SARASOTA MEMORIAL HOME CARE | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90661 | $38.93 | 1740558261 - JYOTI SHAH | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90661 | $77.58 | 1942494018 - SANTOSH SHRESTHA | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $38.93 | 1225065220 - RAKESH CHANDRA | 371041283 - (IL) CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $36.04 | 1366883555 - DAVID BANAYAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $36.34 | 1508986308 - COREY GOLDSTEIN | 911779996 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $38.93 | 1699781310 - GHASSAN ALDURRA | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $32.45 | 1225211600 - JOHN MILLICHAP | 911352172 - MULTICARE HEALTH SYSTEM | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90661 | $38.29 | 1184661407 - MICHAEL BEDNARZ | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $36.34 | 1912385295 - ALYSSA STRAM | 911780160 | NY | Psychiatry Physician (2084P0800X) |
United | 90661 | $46.47 | 1568705622 - IUNIA DADARLAT | 352030653 - ARNETT CLINIC LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $36.04 | 1033347125 - DAVID HANRAHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 90661 | $38.93 | 1063520781 - ELLIOT GERSHON | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 90661 | $38.93 | 1477781649 - BRADLEY CUTLER | 581672987 - (IL) EDWARD HEALTH VENTURES | 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 90661 vs. Other Vaccines, Toxoids Codes
The CPT 90661 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 90661 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 |
|---|---|---|
| 90653 | Low | Influenza Vaccine Inactivated (Iiv) Subunit Adjuvanted For Intramuscular Use (Desc Revised 7/1/2015) Second Or Third Opinion Comprehensive Consult (Old Description -Deleted 3/31/2003) |
| 90654 | Low | Influenza Virus Vaccine Trivalent (Iiv3) Split Virus Preservative-Free For Intradermal Use (Desc Revised 01/01/15) |
| 90655 | Low | Influenza Virus Vaccine Trivalent (Iiv3) Split Virus Preservative Free 0.25 Ml Dosage For Intramuscular Use. (Desc Revised 1/1/2017) |
| 90661 | Low | Influenza Virus Vaccine (Cciiv3) Derived From Cell Cultures Subunit Preservative And Antibiotic Free 0.5 Ml Dosage For Intramuscular Use. (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90661. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90661 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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