CPT 90912 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 • Biofeedback Services and Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GP - Services delivered under an outpatient physical therapy plan of care • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 90912 by major payers:
$89.52
$103.63
$101.58
$138.37
| 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 90912 | ||||||
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CPT 90912 vs. Other Biofeedback Services and Procedures Codes
The CPT 90912 code is part of the Medicine Services and Procedures services used for Biofeedback 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 90912 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 |
|---|---|---|
| 90887 | Low | Interpretation Or Explanation Of Results Of Psychiatric, Other Medical Examinations And Procedures, Or Other Accumulated Data To Family Or Other Responsible Persons, Or Advising Them How To Assist Patient |
| 90889 | Low | Preparation Of Report Of Patient S Psychiatric Status, History, Treatment, Or Progress (Other Than For Legal Or Consultative Purposes) For Other Individuals, Agencies, Or Insurance Carriers |
| 90899 | Moderate | Unlisted Psychiatric Service Or Procedure |
| 90912 | Low | Biofeedback Training Perineal Muscles Anorectal Or Urethral Sphincter Including Emg And/Or Manometry When Performed; Initial 15 Minutes Of One-On-One Physician Or Other Qualified Health Care Professional Contact With The Patient |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90912. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90912 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
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