CPT 90947 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 • G1 - URR reading <60 • G5 - Most recent URR reading of 75 or greater |
| Complexity Level | Low |
National average reimbursement for CPT 90947 by major payers:
$162.88
$157.90
$168.47
$194.69
| 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 90947 | ||||||
United | 90947 | $128.88 | 1144267865 - NITIN PATEL | 462706345 | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90947 | $161.58 | 1962589390 - KATHLEEN KELLEY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90947 | $243.25 | 1083681654 - DAVID SCHILLING | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90947 | $164.82 | 1275564197 - PAUL BERKOWITZ | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | AZ | Psychiatry Physician (2084P0800X) |
United | 90947 | $232.96 | 1144203753 - HAIDAR KABBANI | 911780160 | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90947 | $181.90 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 90947 | $347.00 | 1851490791 - TANYA ROYSTER | 371206525 - QUINCY PHYSICIANS & SURGEONS CLINIC S.C. D/B/A QUINCY MEDICAL GROUP | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90947 | $113.22 | 1669467684 - DAVID MILLER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 90947 | $262.39 | 1164786836 - REBECCA GILFILLAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90947 | $262.39 | 1215968755 - STACEY OCCOMY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IN | Psychiatry Physician (2084P0800X) |
United | 90947 | $101.90 | 1194430504 - JULIA LOZA-VEGA | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physician Assistant (363A00000X) |
United | 90947 | $241.52 | 1265883375 - JOCELYN LORENZO | 274026658 | LA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90947 | $215.03 | 1144267865 - NITIN PATEL | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90947 | $117.16 | 1144267865 - NITIN PATEL | 462706345 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90947 | $240.72 | 1952460933 - LARISSA CHISM BUGGS | 810231784 - BILLINGS CLINIC | IL | 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 90947 vs. Other Dialysis Services and Procedures Codes
The CPT 90947 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 90947 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 |
| 90947-CPT | Low | Dialysis Procedure Other Than Hemodialysis (Eg Peritoneal Dialysis Hemofiltration Or Other Continuous Renal Replacement Therapies) Requiring Repeated Evaluation By A Physician Or Other Qualified Health Care Professional With Or Without Substantial Revision Of Dialysis Prescription (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 90947. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90947 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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