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See a sample rate comparisonCPT 90736 Fee Schedule
Last Verified: October 2026
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.
Shingles Vaccine Solution, Shingles Vaccine. This Vaccine Is Given To Prevent Shingles A Painful Skin Rash That Is Caused By The Same Virus That Causes Chickenpox.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Vaccines, Toxoids |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 95 - Telemedicine - audio and video SL |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90736 |
| Medicaid Fee Schedule | $161.995 median of the 8 states in the free preview · View Medicaid rates for 90736 |
National average reimbursement for CPT 90736 by major payers:
$125.16
$243.20
$232.50
$250.03
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CPT 90736
5 of 25 sample ratesHigher to lower in this preview
Baycare Home Care, Inc.
Baycare Home Care Inc
$313.66Published rateNicholas Hatzis
$258.48Published rateDavid Banayan
$245.33Published rateMolly Mcintosh
Baycare Medical Group Inc
$219.05Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$102.08Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 90736 vs. Other Vaccines, Toxoids Codes
The CPT 90736 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 90736 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 |
|---|---|---|
| 90385-CPT | Low | Preventive For Rh Blood Type, An Iv Treatment To Prevent Complications In A Pregnancy Where The Mother And Fetus Have Rh-Opposite Blood Types. |
| 90471-CPT | Low | Immunization Administration (I, Immunization Administration (Includes Percutaneousintradermal Subcutaneous Intramuscular And Jet Injections Andor Intranasal Or Oral Administration) Single Or |
| 90736-CPT | Low | Shingles Vaccine Solution, Shingles Vaccine. This Vaccine Is Given To Prevent Shingles A Painful Skin Rash That Is Caused By The Same Virus That Causes Chickenpox. |
| 90750-CPT | Low | Zoster (Shingles) Vaccine (Hzv) Recombinant Sub-Unit Adjuvanted For Intramuscular Injection (Reinstated 01/01/2017) Preventive Medicine Adult New Pt (Del 03/31/2003) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90736. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90736 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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