CPT 93798 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments • KX - Requirements specified in the medical policy have been met |
| Complexity Level | Low |
National average reimbursement for CPT 93798 by major payers:
$31.96
$33.17
$34.74
$42.28
| 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 93798 | ||||||
United | 93798 | $26.04 | 1003965955 - CHRISTOPHER LOYND | 371305510 - TOUCHETTE REGIONAL HOSPITAL INC | IL | Psychiatry Physician (2084P0800X) |
United | 93798 | $40.95 | 1932309325 - MEHDI QALBANI | 852340442 | LA | Psychiatry Physician (2084P0800X) |
United | 93798 | $53.22 | 1003869553 - MALEEHA AHSAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93798 | $55.20 | 1225211600 - JOHN MILLICHAP | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93798 | $38.25 | 1073697132 - FEDRA NAJJAR | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93798 | $50.09 | 1710206545 - NEIL JARIWALA | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 93798 | $62.24 | 1740505569 - MEGHAN O'NEILL | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93798 | $60.00 | 1801164967 - DA PEDIATRIC REHABILITATION | 270939565 - (FL) DA PEDIATRIC REHABILITATION | FL | Home Health Agency (251E00000X) |
United | 93798 | $34.08 | 1679526784 - ELTON SMITH | 911031583 | NC | Psychiatry Physician (2084P0800X) |
United | 93798 | $16.71 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 93798 | $49.70 | 1174859284 - MATTHEW NIEDZWIECKI | 811324691 | WI | Psychiatry Physician (2084P0800X) |
United | 93798 | $32.77 | 1962431726 - MARTINS ADEOYE | 432081789 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93798 | $60.84 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 93798 | $171.75 | 1871912683 - LAUREN SCHUMACHER | 943281660 | IL | Psychiatry Physician (2084P0800X) |
United | 93798 | $42.77 | 1952795254 - MALCOLM VANDREVALA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | 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 |
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CPT 93798 vs. Other Cardiovascular Procedures Codes
The CPT 93798 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 93798 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 |
|---|---|---|
| 93792-CPT | Low | Patient/Caregiver Training For Initiation Of Home International Normalized Ratio (Inr) Monitoring Under The Direction Of A Physician Or Other Qualified Health Care Professional Face-To-Face Includingu00a0use And Care Of The Inr Monitor Obtaining Blood Sample Instructions For Reportinghome Inr Test Results And Documentation Of Patients/Caregiver-S Ability To Perform Testing And Report Results |
| 93793-CPT | Low | Anticoagulant Management For A Patient Taking Warfarin Must Include Review And Interpretation Of A New Home Office Or Lab International Normalized Ratio (Inr) Test Result Patient Instructions Dosage Adjustment (As Needed) And Scheduling Of Additional Test(S) When Performed |
| 93798-CPT | Low | Physician Or Other Qualified Health Care Professional Services For Outpatient Cardiac Rehabilitation; With Continuous Ecg Monitoring (Per Session) (Revised 01/01/13) |
| 93880-CPT | Moderate | Duplex Scan Extracrani Art;Comp Bil |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93798. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93798 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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