CPT 90713 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 • 71 - Public Health Clinic • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • SL • EP - Residential facility to Physician's office |
| Complexity Level | Moderate |
National average reimbursement for CPT 90713 by major payers:
$45.47
$47.34
$51.04
$242.82
| 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 90713 | ||||||
United | 90713 | $45.91 | 1063863470 - MARIAN THOMPSON | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 90713 | $53.27 | 1326087669 - LINDA REILMAN | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 90713 | $49.25 | 1598473092 - MONICA DHADUK | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 90713 | $45.91 | 1134887185 - SARAH ROSARIO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 90713 | $45.91 | 1508252784 - MOHAMMAD-ALI YAZDANI ABYANEH | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Dermatology Physician (207N00000X) |
United | 90713 | $49.25 | 1497534705 - MICHELLE PALUMBO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 90713 | $49.25 | 1043204258 - CELESTA HUNSIKER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Internal Medicine Physician (207R00000X) |
United | 90713 | $50.54 | 1609657287 - ASHLEY PARMENTIER | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 90713 | $50.59 | 1093976847 - CATHERINE DOCOUS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 90713 | $40.65 | 1245881473 - EMILY HIDALGO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | MA | Family Nurse Practitioner (363LF0000X) |
United | 90713 | $50.59 | 1326764358 - JESSICA BRUTSKY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 90713 | $49.20 | 1457767295 - MEGHAN FRYE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Surgical Physician Assistant (363AS0400X) |
United | 90713 | $50.74 | 1861605602 - DAVID ISON | 310667480 - (OH) PROFESSIONAL RADIOLOGY, INC. | IL | Diagnostic Radiology Physician (2085R0202X) |
United | 90713 | $72.86 | 1942208616 - ST. LUKE'S COMMUNITY HEALTH SERVICES, ST. LUKE'S THE WOODLANDS HOSPITAL | 760536234 - (TX) ST LUKES COMMUNITY HEALTH SERVICES | TX | General Acute Care Hospital (282N00000X) |
United | 90713 | $53.52 | 1174572416 - DALLAS VAMC | 756108647 | TX | General Acute Care Hospital (282N00000X) |
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 90713 vs. Other Vaccines, Toxoids Codes
The CPT 90713 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 90713 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 | 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) |
| 90713 | Low | Immunization; Poliomyelitis Vaccine |
| 90715 | Low | Tetanus Diphtheria Toxoids And Acellular Pertussis Vaccine (Tdap) When Administered To Individuals 7 Years Or Older For Intramuscular Use |
| 90723 | Low | Diphtheria Tetanus Toxoids Acellular Pertussis Vaccine Hepatitis B And Inactivated Poliovirus Vaccine Inactivated (Dtap-Hepb- Ipv) For Intramuscular Use (Desc Revised 01/01/15) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90713. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90713 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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