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See a sample rate comparisonCPT 96910 Fee Schedule
Last Verified: October 2026
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.
Photochemothrapy; Tar & Ultravio B (Goeckerman Treatmn) Or Pet, Photochemotherapy; Tar And Ultraviolet B (Goeckerman Treatment) Or Pet
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Special Dermatological Procedures |
| Common Place of Service | 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $114.90 national non-facility rate (2026) · View Medicare rates for 96910 |
| Medicaid Fee Schedule | $92.37 median of the 8 states in the free preview · View Medicaid rates for 96910 |
National average reimbursement for CPT 96910 by major payers:
$133.69
$118.31
$127.21
$161.74
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CPT 96910
5 of 25 sample ratesHigher to lower in this preview
Kanade Shinkai
$858.47Published rateMarjon Vatanchi
Regents Of The University Of California At Irvine
$548.48Published rateNatalia Vecerek
Usc Care Medical Group Inc
$287.20Published rateChanghyun Kim
$135.55Published rateHai Tran
$30.47Published rate
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See a sample payer proposalCPT 96910 vs. Other Special Dermatological Procedures Codes
The CPT 96910 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 96910 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 |
|---|---|---|
| 96910-CPT | Low | Photochemothrapy; Tar & Ultravio B (Goeckerman Treatmn) Or Pet, Photochemotherapy; Tar And Ultraviolet B (Goeckerman Treatment) Or Pet |
| 96912-CPT | Low | Photochemotherapy; Puva |
| 96913-CPT | Low | Photochemotx Sev Dermatoses, Photochemotherapy (Goeckerman And/Or Puva) For Severe Photoresponsive Dermatoses Requiring At Least 4-8 Hours Of Care Under Direct Supervision Of The Physician (Includes Application Of Medication And Dressings) |
| 96920-CPT | Low | Laser Treatmn For Inflammat Skin Diseas (Psoriasis); Total Area, Laser Treatment For Inflammatory Skin Disease (Psoriasis); Total Area |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96910. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 96910 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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