CPT 90935 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 • Dialysis Services and Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 99 - Other POS |
| Common Modifiers | • None • G5 - Most recent URR reading of 75 or greater • V7 - Arteriovenous fistula |
| Complexity Level | Low |
National average reimbursement for CPT 90935 by major payers:
$96.26
$93.18
$98.61
$114.60
| 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 90935 | ||||||
United | 90935 | $144.77 | 1730263617 - MARK ALTER | 910844563 | CA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90935 | $124.02 | 1255892808 - ASHLEY SHI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90935 | $77.80 | 1710328703 - ALI ANWAR | 815143225 - (IL) COMMUNITY HOME PHYSICIANS LLC D/B/A COMMUNITY PHYSICIANS | MO | Psychiatry Physician (2084P0800X) |
United | 90935 | $118.59 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 90935 | $114.80 | 1942330576 - NASIR SYED | 364132865 - (IL) PRIMARY HEALTHCARE ASSOCIATES SC | IL | Psychiatry Physician (2084P0800X) |
United | 90935 | $127.23 | 1689166027 - ANIRUDDHA DEKA | 911780160 | CT | Psychiatry Physician (2084P0800X) |
United | 90935 | $80.58 | 1326465436 - MUSADDIQ TARIQ | 510064318 - BAYHEALTH MEDICAL CENTER INC | IL | Psychiatry Physician (2084P0800X) |
United | 90935 | $136.97 | 1508986308 - COREY GOLDSTEIN | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90935 | $65.46 | 1699074518 - LAURA CONTINETTI | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 90935 | $79.18 | 1447243241 - MEDEIA GARTEL | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 90935 | $113.76 | 1568752665 - ANDREW KNOX | 363907436 - ROCKFORD HEALTH PHYSICIANS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90935 | $159.00 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | CO | Psychiatry Physician (2084P0800X) |
United | 90935 | $90.23 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 90935 | $64.98 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | AZ | Psychiatry Physician (2084P0800X) |
United | 90935 | $151.64 | 1518037126 - MARY LAKE | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 90935 vs. Other Dialysis Services and Procedures Codes
The CPT 90935 code is part of the Medicine Services and Procedures services used for Dialysis 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 90935 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 |
|---|---|---|
| 90935-CPT | Low | Hemodialysis Procedure With Single Evaluation By Physician Or Other Qualified Health Care Professional (Revised 1/1/2013) |
| 90937-CPT | Low | Hemodialysis Procedure Requiring Repeated Evaluation(S) With Or Without Substantial Revision Of Dialysis Prescript |
| 90940-CPT | Low | Hemodial Access Bld Flow Study In Grafts/Fistulae By Indicatr Dilution |
| 90945-CPT | Low | Dialysis Procedure Other Than Hemodialysis (Eg Peritoneal Dialysis Hemofiltration Or Other Continuous Renal Replacement Therapies) With Single Evaluation By A Physician Or Other Qualified Health Care Professional (Revised 1/1/13) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90935. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90935 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 90935) and we'll show you how you compare in 15 minutes or less.