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 | Low |
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 | $32.84 | 1063905339 - KATHRYN ABELL | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | DC | Psychiatry Physician (2084P0800X) |
United | 90700 | $29.50 | 1518431576 - AMANDA FIELD | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Surgical Physician Assistant (363AS0400X) |
United | 90700 | $29.05 | 1730263617 - MARK ALTER | 910844563 | NJ | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90700 | $32.29 | 1760412621 - RHONDA LAMPEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 90700 | $32.54 | 1558620146 - RAUNAK KHISTY | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90700 | $45.13 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90700 | $37.77 | 1710275110 - PRAVESH DEOTALE | 430654872 - ST LOUIS UNIVERSITY | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90700 | $29.50 | 1972530996 - PATRICIA WRIGHT | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Occupational Therapist (225X00000X) |
United | 90700 | $50.86 | 1144267865 - NITIN PATEL | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90700 | $32.08 | 1437298361 - ALIYA HAFEEZ | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $39.53 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 90700 | $38.68 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 90700 | $24.00 | 1790390722 - SOPHIA KECALA | 364127904 - (IL) KECALA KECALA SC | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $39.34 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90700 | $29.05 | 1245252303 - MARY FAHRMEIER | 910844563 | 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 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-CPT | 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-CPT | 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-CPT | 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-CPT | 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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