CPT 90993 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 • None |
| Common Modifiers | • None • G1 - URR reading <60 • V5 - Any vascular catheter |
| Complexity Level | Low |
National average reimbursement for CPT 90993 by major payers:
$102.31
$102.27
$132.20
$128.96
| 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 90993 | ||||||
United | 90993 | $135.88 | 1184815870 - RYAN COATES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90993 | $220.61 | 1568752665 - ANDREW KNOX | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90993 | $129.91 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | OK | Psychiatry Physician (2084P0800X) |
United | 90993 | $104.08 | 1205125473 - KELLEY VOLPE | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 90993 | $135.88 | 1992961643 - CYNTHIA GORDON | 815174138 - (IL) ILLINOIS PROFESSIONALS HEALTH PROGR | IL | Psychiatry Physician (2084P0800X) |
United | 90993 | $98.95 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90993 | $169.02 | 1104046630 - SYED WALIUDDIN | 262522053 - (IL) VALLEY PSYCHIATRY AND COUNSELING LLC | IL | Psychiatry Physician (2084P0800X) |
United | 90993 | $96.86 | 1447243241 - MEDEIA GARTEL | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 90993 | $135.88 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IA | Psychiatry Physician (2084P0800X) |
United | 90993 | $169.02 | 1215968755 - STACEY OCCOMY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IN | Psychiatry Physician (2084P0800X) |
United | 90993 | $96.86 | 1205064011 - LAUREL CLARK | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 90993 | $290.22 | 1386969079 - ADAM WALLACE | 391678306 - AURORA MEDICAL GROUP INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 90993 | $160.17 | 1518033836 - LURIE CHILDREN'S MEDICAL GROUP, LCMG SPECIALTY SERVICES | 205734385 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90993 | $157.28 | 1730263617 - MARK ALTER | 910844563 | CA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 90993 | $172.88 | 1447264932 - CYNTHIA STACK | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | 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 90993 vs. Other Dialysis Services and Procedures Codes
The CPT 90993 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 90993 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 |
| 90989-CPT | Moderate | Dialysis Trng, Pt, Helper, Any Mode, Com |
| 90993-CPT | Low | Dialysis Training, Patient, Including Helper Where Applicable, Any Mode, Course Not Completed, Per Training Session |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 90993. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 90993 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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