CPT 90702 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 20 - Urgent Care Facility |
| Common Modifiers | None SL SE - Scene to Residential facility |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90702 |
| Medicaid Fee Schedule | View Medicaid rates for 90702 |
National average reimbursement for CPT 90702 by major payers:
$75.06
$74.68
$67.16
$263.41
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90702 | $66.08 | 1730263617 - MARK ALTER | 910844563 | CA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90702 | $86.91 | 1740252972 - DAVID HSU | 363907436 - ROCKFORD HEALTH PHYSICIANS | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90702 | $66.08 | 1821447285 - CHERIECE MCNEELY | 362235167 - ROSECRANCE INC | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $66.08 | 1366890857 - STEVEN SHARP | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $86.91 | 1386969079 - ADAM WALLACE | 363907436 - ROCKFORD HEALTH PHYSICIANS | MN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90702 | $88.36 | 1841721925 - CHELSEA CURRY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $75.09 | 1013112333 - UTPAL DHRUVE | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $66.09 | 1184298713 - TIFFANY VUONG | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 90702 | $108.94 | 1790936540 - SRISHTI NANGIA | 131623978 | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90702 | $71.04 | 1083979124 - RAHUL SHARMA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $67.16 | 1295728186 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90702 | $143.82 | 1871912683 - LAUREN SCHUMACHER | 943281673 | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $79.30 | 1770014920 - JOSEPH PEPITONE | 363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $73.43 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90702 | $74.68 | 1063905339 - KATHRYN ABELL | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | 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 90702 vs. Other Vaccines, Toxoids Codes
The CPT 90702 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 90702 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 |
|---|---|---|
| 90696-CPT | Low | Diphtheria Tetanus Toxoids A, Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine And Poliovirus Vaccine Inactivated (Dtap-Ipv) When Administered To Children 4 Years Through6 Years Of Age For Intramuscular Use |
| 90697-CPT | Low | Dtap Ipv Hib Hepb Vaccine Im, Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Inactivated Poliovirus Vaccine Haemophilus Influenzae Type B Prp Omp Conjugate Vaccine And Hepatitis B Vaccine Dtap Ipv Hib Hepb For Intramuscular Use |
| 90698-CPT | Low | Diphtheria Tetanus Toxoids A, Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Inactivated Poliovirus Vaccine Haemophilus Influenzae Type B Prp-Omp Conjugate Vaccine Andhepatitis B Vaccine (Dtap-Ipv-Hib-Hepb) For Intr |
| 90702-CPT | Low | Diphtheria And Tetanus Toxoids, Diphtheria And Tetanus Toxoids Adsorbed (Dt) 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 90702. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90702 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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