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CPT 96920 Fee Schedule

Last Verified: November 2025

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.

Laser Treatment For Inflammatory Skin Disease (Psoriasis); Total Area Less Than 250 Sq. Cm
Key FactDetail
Service Type

Medicine Services and Procedures

Special Dermatological Procedures

Common Place of Service

11 - Office

None

Common Modifiers

None

59 - Distinct Procedural Service

79 - Unrelated procedure - postop period

Complexity LevelLow

National average reimbursement for CPT 96920 by major payers:

bcbs

$194.37

uhc

$206.96

aetna

$208.28

cigna

$256.52

Preview provider-level rates for...
For billing codeCPT 96920
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 96920

United
96920$178.611114472867 - MARCUS BYRD132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATIONILPsychiatry Physician (2084P0800X)
United
96920$259.361376063370 - ABBY FREDRICKSON364015560 - LOYOLA UNIVERSITY MEDICAL CENTERMNPsychiatry Physician (2084P0800X)
United
96920$259.211639438997 - ANTHONY JEDD462494918 - INTEGRATED IMAGING CONSULTANTS, LLCCADiagnostic Radiology Physician (2085R0202X)
United
96920$363.941558724641 - ERIC MORGAN232743545PAAnatomic Pathology Physician (207ZP0101X)
United
96920$548.561487670782 - SIMON POWELL593801080NYRadiation Oncology Physician (2085R0001X)
United
96920$206.601932295227 - JOHN KIRKPATRICK202999870NCRadiation Oncology Physician (2085R0001X)
United
96920$167.421467682971 - KIMBERLY JOHNSON381908328 - GREAT LAKES BAY HEALTH CENTERSMIDiagnostic Radiology Physician (2085R0202X)
United
96920$596.951427013408 - DARA LIFSCHUTZ363261413 - ALLINA HEALTH SYSTEMMODiagnostic Radiology Physician (2085R0202X)
United
96920$261.481013025345 - MARTIN FINE800756169NYDiagnostic Radiology Physician (2085R0202X)
United
96920$252.311831306968 - LANDON PRYOR362222696 - SWEDISHAMERICAN HOSPITALILPlastic Surgery Physician (208200000X)
United
96920$210.791194764738 - CHRISTOPHER HA831368814 - INTEGRATED DERMATOLOGY OF ROSEVILLE PCCADermatology Physician (207N00000X)
United
96920$444.521588872212 - REORDAN DE JESUS591680273 - FLORIDA CLINICAL PRACTICE ASSOCIATION INCFLDiagnostic Radiology Physician (2085R0202X)
United
96920$191.761962662684 - LISA LONGHOFER472729518 - LISA K. LONGHOFER, MD PLLCTXOrthopaedic Surgery Physician (207X00000X)
United
96920$402.911386672780 - RONALD HENDRIX363097297 - NORTHWESTERN MEMORIAL HEALTHCAREILDiagnostic Radiology Physician (2085R0202X)
United
96920$270.151629502208 - NATHANIEL CAMDEN911780160ILRadiation Oncology Physician (2085R0001X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 96920 vs. Other Special Dermatological Procedures Codes

The CPT 96920 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 96920 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.

CodeComplexityDescription
96912-CPTLowPhotochemotherapy; Puva
96913-CPTLowPhotochemotherapy (Goeckerman And/Or Puva) For Severe Photoresponsive Dermatoses Requiring At Least Four To Eight Hours Of Care Under Direct Supervision Of The Physician (Includes Application Of Medication And Dressings)
96920-CPTLowLaser Treatment For Inflammatory Skin Disease (Psoriasis); Total Area Less Than 250 Sq. Cm
96921-CPTModerateLaser Treatment For Inflammatory Skin Disease (Psoriasis); 250 Sq Cm To 500 Sq Cm

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 96920. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 96920 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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