CPT 90962 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 | • 99 - Other POS • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 95 - Telemedicine - audio and video • AQ - Service in Health Professional Shortage Area |
| Complexity Level | Moderate |
National average reimbursement for CPT 90962 by major payers:
$250.22
$234.51
$241.89
$317.48
| 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 90962 | ||||||
United | 90962 | $319.13 | 1376001701 - SAMANTHA PATEL | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $434.60 | 1669524369 - JENNIFER KURTH | 205734385 | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $328.92 | 1538112859 - FARHA TOKARZ | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90962 | $281.51 | 1033215868 - MOHAMMED ALI | 320552496 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90962 | $331.94 | 1225211600 - JOHN MILLICHAP | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90962 | $331.94 | 1225211600 - JOHN MILLICHAP | 460319070 - MONUMENT HEALTH RAPID CITY HOSPITAL INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90962 | $343.55 | 1730246067 - SENADA BAJMAKOVIC-KACILA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $170.09 | 1497923288 - RYAN MIYAMOTO | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 90962 | $386.97 | 1164786836 - REBECCA GILFILLAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $364.00 | 1245252303 - MARY FAHRMEIER | 910844563 | WI | Psychiatry Physician (2084P0800X) |
United | 90962 | $415.60 | 1063471159 - MARK WAINWRIGHT | 911220843 - ASSOCIATION OF UNIVERSITY PHYSICIANS | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90962 | $297.45 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $159.35 | 1366442600 - MICHAEL JACOBSON | 541958039 - HROA 401K PLAN | VA | Otolaryngology Physician (207Y00000X) |
United | 90962 | $289.80 | 1326306937 - ANU MATHUR | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 90962 | $236.14 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | AZ | 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 90962 vs. Other Dialysis Services and Procedures Codes
The CPT 90962 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 90962 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 |
|---|---|---|
| 90957-CPT | Moderate | End-Stage Renal Disease (Esrd) Related Services Monthly For Patients 12-19 Years Of Age To Include Monitoring For The Adequacy Of Nutrition Assessment Of Growth And Development And Counseling Of Parents; With 4 Or More Face- To-Face Visits By A Physician Or Other Qualified Health Care Professional Per Month (Revised 1/1/2013) |
| 90958-CPT | Moderate | End-Stage Renal Disease (Esrd) Related Services Monthly For Patients 12-19 Years Of Age To Include Monitoring For The Adequacy Of Nutrition Assessment Of Growth And Development And Counseling Of Parents; With 2-3 Face-To-Face Visits By A Physician Or Other Qualified Health Care Professional Per Month (Revised 1/1/2013) |
| 90959-CPT | Moderate | End-Stage Renal Disease (Esrd) Related Services Monthly For Patients 12-19 Years Of Age To Include Monitoring For The Adequacy Of Nutrition Assessment Of Growth And Development And Counseling Of Parents; With 1 Face-To-Face Visit By A Physician Or Other Qualified Health Care Professional Per Month (Revised 1/1/13) |
| 90962-CPT | Moderate | End-Stage Renal Disease (Esrd) Related Services Monthly For Patients 20 Years Of Age And Older; With 1 Face-To-Face Visit By A Physician Or Other Qualified Health Care Professional Per Month(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 90962. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90962 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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