CPT 97802 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 • Medical Nutrition Therapy Procedures |
| Common Place of Service | • 11 - Office • None |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 97802 |
National average reimbursement for CPT 97802 by major payers:
$40.42
$43.46
$55.71
$44.16
| 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 97802 | ||||||
United | 97802 | $43.41 | 1003842618 - RADHA MIKKILINENI | 821246273 - SCHEINER DERMATOLOGY PLLC | DC | Dermatopathology Physician (207ND0900X) |
United | 97802 | $73.19 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | VA | Psychiatry Physician (2084P0800X) |
United | 97802 | $40.68 | 1225100449 - ELITA BALAKRISHNAN | 900603487 - (NY) PHYSICIAN AFFILIATE GROUP OF NEW YORK PC | NY | Pediatrics Physician (208000000X) |
United | 97802 | $248.69 | 1972967511 - LAKSHMI NIRANJANA DHANABALAN | 943281657 | CA | Pediatrics Physician (208000000X) |
United | 97802 | $76.58 | 1992198154 - MOHAMED SALEH | 232919472 - UPMC | PA | Pediatric Endocrinology Physician (2080P0205X) |
United | 97802 | $94.55 | 1104230036 - AFSANEH TALAI | 756002868 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97802 | $86.47 | 1477624138 - LAWRENCE EICHENFIELD | 951691313 - RADY CHILDRENS HOSPITAL-SAN DIEGO | CA | Pediatric Dermatology Physician (207NP0225X) |
United | 97802 | $62.06 | 1265484190 - ASAD SAEED | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | MN | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 97802 | $105.98 | 1528504891 - DOUGLAS MAILMAN | 352346161 | WA | Pediatrics Physician (208000000X) |
United | 97802 | $68.29 | 1407919772 - LISA KOSLOW | 204762421 - (NY) ALLIED PHYSICIANS GROUP PLLC | NY | Pediatrics Physician (208000000X) |
United | 97802 | $139.33 | 1386969079 - ADAM WALLACE | 391678306 - AURORA MEDICAL GROUP INC | MN | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 97802 | $40.95 | 1326698333 - GINA BARBETTA | 320605812 - (PA) THE CHARGE GROUP LLC | CT | Registered Dietitian (133V00000X) |
United | 97802 | $53.93 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 97802 | $39.00 | 1548602873 - SARAH MILAZZO | 421571876 - (NY) JERICHO ROAD MINISTRIES | NY | Pediatrics Physician (208000000X) |
United | 97802 | $70.63 | 1639146368 - DEBORAH COUCH | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | 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 97802 vs. Other Medical Nutrition Therapy Procedures Codes
The CPT 97802 code is part of the Medicine Services and Procedures services used for Medical Nutrition Therapy 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 97802 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 |
|---|---|---|
| 97763-CPT | Low | Orthotic(S)/Prosthetic(S) Management And/Or Training Upper Extremity(Ies) Lower Extremity(Ies) And/Or Trunk Subsequent Orthotic(S)/Prosthetic(S) Encounter Each 15 Minutes |
| 97799-CPT | Moderate | Unlisted Physical Medicine/Rehabilitation Service Or Procedure |
| 97802-CPT | Low | Medical Nutrition Therapy; Initial Assessment And Intervention, Individual, Face-To-Face With The Patient, Each 15 Minutes |
| 97803-CPT | Low | Medical Nutrition Therapy; Re-Assessment And Intervention, Individual, Face-To-Face With The Patient, Each 15 Minutes |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 97802. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 97802 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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