CPT 90690 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 71 - Public Health Clinic |
| Common Modifiers | None GA - Required ABN issued and on file GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90690 |
National average reimbursement for CPT 90690 by major payers:
$95.56
$110.08
$115.88
$117.20
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90690 | $96.00 | 1437869229 - JASON LIOU | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 90690 | $121.20 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IA | Psychiatry Physician (2084P0800X) |
United | 90690 | $90.25 | 1881012235 - LAUREN PREST | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $121.20 | 1356352447 - MARLA HARTZEN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $164.27 | 1871912683 - LAUREN SCHUMACHER | 943281657 | CA | Psychiatry Physician (2084P0800X) |
United | 90690 | $114.65 | 1760778468 - NATHAN ONTROP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $76.70 | 1033117007 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90690 | $121.20 | 1760778468 - NATHAN ONTROP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $142.61 | 1871592881 - CHANDRAGUPTA VEDAK | 363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $120.54 | 1790214674 - JENNIFER HARKEY | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $106.67 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 90690 | $142.61 | 1609239243 - MEGAN GINSBURG | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $121.20 | 1033328869 - LEAH USTAS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90690 | $106.66 | 1760412621 - RHONDA LAMPEN | 910844563 | WI | Psychiatry Physician (2084P0800X) |
United | 90690 | $125.87 | 1689622029 - TERESA SRIPADA | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | 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 90690 vs. Other Medicine Services and Procedures Codes
The CPT 90690 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 90690 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 |
|---|---|---|
| 90657-CPT | Low | Influenza Virus Vaccine Triva, Influenza Virus Vaccine Trivalent (Iiv3) Split Virus When Administered To Children 6-35 Months Ofage For Intramuscular Use |
| 90673-CPT | Low | Influenza Virus Vaccine Triva, Influenza Virus Vaccine Trivalent (Riv3) Derivedfrom Recombinant Dna (Riv3) Hemagglutinin (Ha) P Rotein Only Preservative And Antibiotic Free Forintramuscular Use |
| 90681-CPT | Low | Oral Vaccine For Rotavirus, Rotavirus Vaccine Solution For Oral (By Mouth) Use. The Vaccine Is Given To Prevent Infection With The Rotavirus A Virus Which Causes Severe Diarrhea. |
| 90690-CPT | Low | Typhoid Vaccine For Oral Use, Typhoid Vaccine Solution Given By Mouth (Oral). Typhoid Is A Bacteria That Can Cause Serious Infection. It Is Spread By Contaminated Food And Water. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90690. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90690 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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