CPT 90739 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 | Vaccines, Toxoids Medicine Services and Procedures |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | None SL UD |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90739 |
National average reimbursement for CPT 90739 by major payers:
$151.43
$165.66
$192.82
$186.44
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 90739 | $180.89 | 1518124932 - RITU TALWAR | 363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $174.19 | 1043358781 - JOSEPH COOPER | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $143.19 | 1861832321 - SERGIO PEREZ BERACASA | 630888599 - (AL) SOUTHEASTERN CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90739 | $154.66 | 1578097846 - CHRISTOPHER LOMBARDI | 205566098 | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $165.91 | 1497966287 - JAMES TOWERY | 621545731 - BAPTIST MEMORIAL MEDICAL GROUP INC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90739 | $136.80 | 1255478004 - CHRISTOPHER RAIO | 112050523 - ST FRANCIS HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 90739 | $147.63 | 1255598512 - ASTRID HERARD | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $187.50 | 1356397210 - M SHEIKH | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $177.16 | 1114905429 - CHAD ALFORD | 631159436 - (AL) MOBILE HEART SPECIALISTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90739 | $166.82 | 1710914890 - ADNAN ARIF | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 90739 | $177.16 | 1679526784 - ELTON SMITH | 911031583 | NC | Psychiatry Physician (2084P0800X) |
United | 90739 | $174.19 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90739 | $265.73 | 1912282948 - IMRAN KHALIL | 630739971 - (AL) CARDIOLOGY ASSOCIATES, P.A. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 90739 | $147.63 | 1730263617 - MARK ALTER | 910844563 | VA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90739 | $147.63 | 1063490845 - KEVIN SCHLESSEL | 311425166 | OH | Rheumatology Physician (207RR0500X) |
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 90739 vs. Other Medicine Services and Procedures Codes
The CPT 90739 code is part of the Vaccines, Toxoids services used for Medicine Services and Procedures. 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 90739 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. |
| 90396-CPT | High | Solution To Prevent Chickenpox, An Antibody Substance (Gamma Globulin Or Immune Globulin) That Helps To Prevent Infection By The Virus That Causes Chickenpox. This Solution Is Given By Shot. |
| 90739-CPT | Low | Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus. |
| 90740-CPT | Low | Hepatitis B Vaccine Solution, Hepatitis B Vaccine Solution. The Vaccine May Be Given In A Series Of Shots And Provides Protection Against Infection With The Hepatitis B Virus. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90739. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90739 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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