CPT 93245 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 • Cardiovascular Procedures |
| Common Place of Service | • 11 - Office • None • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 93245 |
National average reimbursement for CPT 93245 by major payers:
$305.91
$122.80
$210.45
$480.54
| 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 93245 | ||||||
United | 93245 | $86.29 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93245 | $126.70 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IN | Psychiatry Physician (2084P0800X) |
United | 93245 | $80.37 | 1295736726 - MOHAMED KATERJI | 364473799 - (IL) KATERJI PEDIATRIC NEUROLOGY ASSOC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93245 | $187.47 | 1962791343 - JEREMY WONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93245 | $113.86 | 1679739395 - BETSY OSTRANDER | 942854057 - IHC HEALTH SERVICES INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93245 | $166.27 | 1063471159 - MARK WAINWRIGHT | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | WA | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93245 | $153.82 | 1730263617 - MARK ALTER | 910844563 | VA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93245 | $93.55 | 1760419311 - PETER HEYDEMANN | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93245 | $120.16 | 1043358781 - JOSEPH COOPER | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 93245 | $162.10 | 1760461867 - RITA YADAVA | 363878197 - (IL) RITA YADAVA MDSC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93245 | $192.89 | 1164410502 - ALAN FELTHOUS | 201957741 | IL | Psychiatry Physician (2084P0800X) |
United | 93245 | $119.34 | 1487841540 - CEZARY DUDZINSKI | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93245 | $123.98 | 1972778801 - JOSEPH MULLEN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 93245 | $137.78 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | MN | Psychiatry Physician (2084P0800X) |
United | 93245 | $146.36 | 1356723811 - VICTOR PATRON ROMERO | 911780074 | 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 93245 vs. Other Cardiovascular Procedures Codes
The CPT 93245 code is part of the Medicine Services and Procedures services used for Cardiovascular 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 93245 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 |
|---|---|---|
| 93224-CPT | Low | External Electrocardiographic Recording Up To 48 Hours By Continuous Rhythm Recording And Storage; Includes Recording Scanning Analysis With Report Review And Interpretation By A Physician Or Other Qualified Health Care Professional (Revised 01/01/13) |
| 93225-CPT | Low | External Electrocardiographic Recording Up To 48 Hours By Continuous Rhythm Recording And Storage; Recording (Includes Connection, Recording, And Disconnection) |
| 93245-CPT | Moderate | External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Includes Recording Scanning Analysis With Report Review And Interpretation |
| 93246-CPT | Low | External Electrocardiographic Recording For More Than 7 Days Up To 15 Days By Continuous Rhythm Recording And Storage; Recording (Includes Connection And Initial Recording) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93245. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93245 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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