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See a sample rate comparisonHealthcare 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 | SL SE - Scene to Residential facility |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90702 |
| Medicaid Fee Schedule | $26.15 median of the 7 states in the free preview · View Medicaid rates for 90702 |
National average reimbursement for CPT 90702 by major payers:

$75.06

$74.68

$67.16

$263.41
Choose a payer to see a sample of rates for CPT 90702.
Lauren Schumacher
Adam Wallace
Rockford Health Physicians
Rahul Sharma
Advocate Health And Hospitals Corporation
Cheriece Mcneely
Rosecrance Inc
All Ways Homecare Inc
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 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 |
| 90700-CPT | Low | Dtap Vaccine Solution, A Dtap Solution Prepared For Vaccination Of A Child Up To Age 7. The Solution Is Intended To Protect Against Diphtheria Tetanus And Whooping Cough (Pertussis). |
| 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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