CPT 90743 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 • 50 - Federally Qualified Health Center |
| Common Modifiers | • None • SL • UD |
| Complexity Level | Moderate |
National average reimbursement for CPT 90743 by major payers:
$73.96
$76.67
$81.95
$79.18
| 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 90743 | ||||||
United | 90743 | $86.19 | 1841721925 - CHELSEA CURRY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $135.00 | 1871912683 - LAUREN SCHUMACHER | 943281673 | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $82.56 | 1063471159 - MARK WAINWRIGHT | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | WA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90743 | $83.16 | 1164786836 - REBECCA GILFILLAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $81.19 | 1194149104 - ADVENTIST HEALTH PARTNERS, INC, SALT CREEK THERAPY CENTER | 371762682 - (IL) ADVENTIST MIDWEST HEALTH | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $77.06 | 1376001701 - SAMANTHA PATEL | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $68.80 | 1962664789 - JAMIE EVANS | 910844563 | NC | Psychiatry Physician (2084P0800X) |
United | 90743 | $77.06 | 1356723811 - VICTOR PATRON ROMERO | 911780074 | IL | Psychiatry Physician (2084P0800X) |
United | 90743 | $76.44 | 1881918415 - TUSHAR ADVANI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MT | Psychiatry Physician (2084P0800X) |
United | 90743 | $82.56 | 1992980379 - JANICE KOWALSKI | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90743 | $120.41 | 1972543080 - HOSSAM ABDELSALAM | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90743 | $101.41 | 1992234611 - USHA APPALANENI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90743 | $68.80 | 1962664789 - JAMIE EVANS | 910844563 | VA | Psychiatry Physician (2084P0800X) |
United | 90743 | $76.44 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | NC | Psychiatry Physician (2084P0800X) |
United | 90743 | $83.16 | 1982268959 - SIDRAH NAJAM | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IN | 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 90743 vs. Other Vaccines, Toxoids Codes
The CPT 90743 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 90743 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 |
|---|---|---|
| 90739 | Low | Hepatitis B Vaccine (Hepb) Cpg-Adjuvanted Adult Dosage 2 Dose Or 4 Dose Schedule For Intramus- Cular Use (Desc Rvsd 7/1/22) |
| 90740 | Low | Hepatitis B Vaccine (Hepb) Dialysis Or Immunosuppressed Patient Dosage 3 Dose Schedule For Intramuscular Use (Desc Rsvd 7/1/2015) |
| 90743 | Low | Hepatitis B Vaccine, Adolescent For Intramuscular Use |
| 90744 | Low | Immunization, Hepatitis B; Pediatric/Adolescent 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 90743. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90743 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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