CPT 90758 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 10 - Telehealth in Patient's Home None 50 - Federally Qualified Health Center |
| Common Modifiers | None 95 - Telemedicine - audio and video U5 GT - Via interactive audio and video telecommunication systems |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 90758 |
National average reimbursement for CPT 90758 by major payers:
$45.64
$N/A
$N/A
$99,999.77
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
No data found No fee schedule data available for the selected payer and code combination | ||||||
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CPT 90758 vs. Other Medicine Services and Procedures Codes
The CPT 90758 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 90758 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 |
|---|---|---|
| 90702-CPT | Low | Diphtheria And Tetanus Toxoids, Diphtheria And Tetanus Toxoids Adsorbed (Dt) When Administered To Individuals Younger Than 7 Years For Intramuscular Use |
| 90733-CPT | Low | Meningitis Vaccine Solution, Meningococcal Vaccine Solution. The Vaccine Is Given To Prevent Infection With The Meningococcus Bacteria Which Can Cause Meningitis (Infection In The Tissue Surrounding The Brain) And Other Serious Infections. |
| 90734-CPT | Low | Meningitis Vaccine Solution, Meningococcal Vaccine Solution. The Vaccine Is Given To Prevent Infection With The Meningococcus Bacteria Which Can Cause Meningitis (Infection In The Tissue Surrounding The Brain) And Other Serious Infections. |
| 90758-CPT | Low | Ebolavirus Vaccine, A Vaccine Solution For The Ebola Virus. The Illness Is Spread By Blood Products Or By Insect And Animal Bites. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90758. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90758 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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