CPT 96902 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 • Special Dermatological Procedures |
| Common Place of Service | • 11 - Office • 81 - Independent Laboratory • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 52 - Reduced Services • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 96902 by major payers:
$30.10
$28.29
$27.91
$35.16
| 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 96902 | ||||||
United | 96902 | $47.70 | 1629177662 - BARBARA TWARDOWSKI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96902 | $24.88 | 1326465436 - MUSADDIQ TARIQ | 510064318 - BAYHEALTH MEDICAL CENTER INC | MS | Psychiatry Physician (2084P0800X) |
United | 96902 | $44.22 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $49.18 | 1790181402 - SONAM VERMA | 611661781 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 96902 | $44.27 | 1447365440 - AYAME TAKAHASHI | 364143823 - SIU PHYSICIANS & SURGEONS INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 96902 | $34.52 | 1194049676 - TRACY BINIUS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $27.57 | 1508986308 - COREY GOLDSTEIN | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $32.81 | 1720547672 - PERRY TSAI | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $33.22 | 1356608988 - TRIXIE LIPKE | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $38.34 | 1104993161 - BETH LEDVORA | 463010946 - (IL) BETH LEDVORA M.D., S.C. | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $29.37 | 1255692794 - MELISSA WAGNER-SCHUMAN | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $42.34 | 1508986308 - COREY GOLDSTEIN | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $25.62 | 1831243831 - PAMELA VERGARA-RODRIGUEZ | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $40.88 | 1093243149 - KRISTIN ROSSEAU | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 96902 | $27.57 | 1205831393 - PRITI SINGH | 461302245 - (IL) ASSOCIATES IN PEDIATRIC NEUROLOGY SC | 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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 96902 vs. Other Special Dermatological Procedures Codes
The CPT 96902 code is part of the Medicine Services and Procedures services used for Special Dermatological 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 96902 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 |
|---|---|---|
| 96902-CPT | Low | Microscopic Examination Of Hairs Plucked Or Clipped By The Examiner (Excluding Hair Collected By The Patient) To Determine Telogen And Anagen Counts, Or Structural Hair Shaft Abnormality |
| 96904-CPT | Low | Whole Body Integumentary Photography For Monitoring Of High Risk Patients With Dysplastic Nevus Syndrome Or A History Of Dysplastic Nevi Or Patients With A Personal Or Familial History Of Melanoma |
| 96920-CPT | Low | Laser Treatment For Inflammatory Skin Disease (Psoriasis); Total Area Less Than 250 Sq. Cm |
| 96931-CPT | Moderate | Reflectance Confocal Microscopy (Rcm) For Cellular And Sub-Cellular Imaging Of Skin; Image Acquisition And Interpretation And Report, First Lesion |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96902. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96902 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 96902) and we'll show you how you compare in 15 minutes or less.