CPT 90875 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 • Psychiatry Services and Procedures |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • None • 59 - Distinct Procedural Service • AJ |
| Complexity Level | Low |
National average reimbursement for CPT 90875 by major payers:
$73.61
$84.07
$75.16
$85.36
| 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 90875 | ||||||
United | 90875 | $133.96 | 1003049966 - GIRISHKUMAR DHORAJIA | 850703768 - (IL) CARLE WEST PHYSICIAN GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $108.45 | 1851558001 - LUBOV ROMANTSEVA | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90875 | $89.44 | 1932355591 - JONATHAN HOWARD | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $131.50 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $125.87 | 1508895897 - SYED IRFAN | 363907436 - ROCKFORD HEALTH PHYSICIANS | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $131.16 | 1831335850 - CLAUDINE SINSIOCO | 540620889 - INOVA HEALTH CARE SERVICES | VA | Psychiatry Physician (2084P0800X) |
United | 90875 | $150.44 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 90875 | $116.76 | 1669598421 - CHANDRIKA SHANKAR | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $142.47 | 1659714806 - RAVI RAMASAMY | 910564748 - SEATTLE CHILDRENS HOSPITAL | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90875 | $116.76 | 1376001701 - SAMANTHA PATEL | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $89.93 | 1275564197 - PAUL BERKOWITZ | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IN | Psychiatry Physician (2084P0800X) |
United | 90875 | $101.08 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $180.30 | 1851558001 - LUBOV ROMANTSEVA | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90875 | $119.81 | 1336431667 - SURAYA KAWADRY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90875 | $62.90 | 1225211600 - JOHN MILLICHAP | 356005697 | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
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 90875 vs. Other Psychiatry Services and Procedures Codes
The CPT 90875 code is part of the Medicine Services and Procedures services used for Psychiatry 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 90875 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 |
|---|---|---|
| 90840-CPT | Low | Psychotherapy For Crisis; Each Additional 30 Minutes (List Separately In Addition To Code For Primary Service) |
| 90845-CPT | Low | Medical Psychoanalysis |
| 90846-CPT | Low | Family Psychotherapy(Without Patient Present) Medicaid Level Of Care 5, As Defined By Each State Nurse Pracitioner Rendering Service In Collaborati |
| 90875-CPT | Low | Individual Psychophysiological Therapy Incorporating Biofeedback Training By Any Modality (Face-To-Face With The Patient) With Psychotherapy (Eg Insight Oriented Behavior Modifying Or Supportive Psychotherapy); 30 Minutes (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90875. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90875 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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