CPT 90672 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 • 71 - Public Health Clinic |
| Common Modifiers | • None • SL • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90672 by major payers:
$26.97
$27.91
$29.03
$37.76
| 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 90672 | ||||||
United | 90672 | $24.70 | 1992018675 - GAUTAM REDDY | 812971996 - (AL) HH HEART CENTER LLC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90672 | $29.14 | 1790936540 - SRISHTI NANGIA | 131623978 | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90672 | $24.70 | 1912282948 - IMRAN KHALIL | 272239880 - (AL) WIREGRASS CLINIC LLC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90672 | $23.75 | 1750461620 - BENJAMIN CITRIN | 814661745 - (AL) CITRIN CARDIOLOGY PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90672 | $30.95 | 1841721925 - CHELSEA CURRY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90672 | $58.50 | 1124003025 - KATHLEEN BOTTUM | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Psychiatry Physician (2084P0800X) |
United | 90672 | $24.70 | 1609883347 - BRAD BERGER | 362709982 - (IL) PRESENCE BEHAVIORAL HEALTH | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90672 | $24.70 | 1730263617 - MARK ALTER | 910844563 | MT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90672 | $29.87 | 1184815870 - RYAN COATES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90672 | $30.95 | 1821097924 - AFTAB POSHNI | 363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90672 | $29.14 | 1508192048 - DIANA SIECIECHOWICZ | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90672 | $27.79 | 1740252972 - DAVID HSU | 391678306 - AURORA MEDICAL GROUP INC | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90672 | $27.79 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 90672 | $27.90 | 1013538636 - OYOYO SAWYER | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 90672 | $35.36 | 1215597554 - MATTEO RESPINO | 351747218 - INDIANA UNIVERSITY HEALTH CARE ASSOCIATES INC | 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 90672 vs. Other Vaccines, Toxoids Codes
The CPT 90672 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 90672 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) |
| 90666 | Low | Influenza Virus Vaccine (Iiv) Pandemic Formulation Split Virus Preservative Free For Intramuscular Use (Desc Revised 7/1/2015) |
| 90672 | Low | Influenza Virus Vaccine Quadrivalent Live (Laiv4) For Intranasal Use (Desc Revised 7/1/2015) |
| 90673 | Low | Influenza Virus Vaccine Trivalent (Riv3) Derivedfrom Recombinant Dna (Riv3) Hemagglutinin (Ha) Protein Only Preservative And Antibiotic Free For Intramuscular Use (Desc Revised 7/1/2015) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90672. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90672 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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