CPT 90700 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 | Moderate |
National average reimbursement for CPT 90700 by major payers:
$31.81
$32.76
$34.78
$32.30
| 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 90700 | ||||||
United | 90700 | $32.54 | 1952569758 - CHARLES HEBERT | 911780160 | CO | Psychiatry Physician (2084P0800X) |
United | 90700 | $36.06 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | CA | Psychiatry Physician (2084P0800X) |
United | 90700 | $39.34 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $40.38 | 1386969079 - ADAM WALLACE | 362222696 - SWEDISHAMERICAN HOSPITAL | MN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90700 | $29.05 | 1215025309 - DEBORAH GARRELTS-DAOUD | 237076080 - (IL) CRUSADERS CENTRAL CLINIC ASSOCIATION | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $32.16 | 1033215868 - MOHAMMED ALI | 320552496 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90700 | $40.38 | 1568752665 - ANDREW KNOX | 363907436 - ROCKFORD HEALTH PHYSICIANS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90700 | $45.13 | 1033117007 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90700 | $31.20 | 1225021124 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90700 | $31.20 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90700 | $32.54 | 1558620146 - RAUNAK KHISTY | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90700 | $33.41 | 1225211600 - JOHN MILLICHAP | 731310891 - WARREN CLINIC INC | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90700 | $35.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 90700 | $34.86 | 1891993754 - PHILIP JANICAK | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $29.05 | 1760412621 - RHONDA LAMPEN | 811324691 | VA | 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 90700 vs. Other Vaccines, Toxoids Codes
The CPT 90700 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 90700 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 |
|---|---|---|
| 90644 | Low | Meningococcal Conjugate Vaccine Serogroups C & Y And Haemophilus Influenzae B Vaccine (Hib-Mency) 4 Dose Schedule When Administered To Children 6 Weeks-18 Months Of Age For Intramuscular Use (Description Revised 1/1/2016) |
| 90696 | Low | Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine And Inactivated Poliovirus Vaccine (Dtap-Ipv) When Administered To Children 4 Through 6 Years Of Age For Intramuscular Use (Desc Revised 7/1/2015) |
| 90697 | Low | Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Inactivated Poliovirus Vaccine Haemophilus Influenza Type B Prp-Omp Conjugate Vaccine And Hepatitis B Vaccine (Dtap-Ipv-Hib- Hepb) For Intramuscular Use |
| 90700 | Low | Diphtheria Tetanus Toxoids And Acellular Pertussis Vaccine (Dtap) When Administered To Individuals Younger Than 7 Years For Intramuscular Use |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90700. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90700 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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