CPT 78195 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 | • Radiology Procedures • Nuclear Medicine Procedures |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 78195 by major payers:

$389.66

$392.94

$422.35

$487.04
| 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 78195 | ||||||
United | 78195 | $742.38 | 1700816717 - DAYTON OUTPATIENT CENTER INC, DOC IMAGING SERVICES | 311642691 - (OH) DAYTON OUTPATIENT CENTER INC | OH | Radiology Clinic/Center (261QR0200X) |
United | 78195 | $397.51 | 1801990825 - SOUTHEAST HEALTH CENTER OF STODDARD COUNTY, LLC, MERCY HOSPITAL STODDARD | 461481133 - (MO) SOUTHEAST HEALTH CENTER OF STODDARD COUNTY LLC | MO | General Acute Care Hospital (282N00000X) |
United | 78195 | $495.57 | 1285664177 - MERCY HOSPITALS EAST COMMUNITIES, MERCY HOSPITAL WASHINGTON | 431066883 - (MO) MERCY HOSPITALS EAST COMMUNITIES | MO | General Acute Care Hospital (282N00000X) |
United | 78195 | $943.96 | 1053382655 - FOLEY HOSPITAL COMPANY LLC, SOUTH BALDWIN REGIONAL MEDICAL CENTER | 621811413 - (AL) FOLEY HOSPITAL CORPORATION | AL | General Acute Care Hospital (282N00000X) |
United | 78195 | $333.92 | 1700125390 - BRITTANY EVERNDEN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Medical Physician Assistant (363AM0700X) |
United | 78195 | $68.25 | 1437696408 - DANIELLE LASKOWITZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 78195 | $402.17 | 1922741933 - KELLY HALLISSEY | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 78195 | $473.16 | 1225226400 - JAMIE HOFFMAN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anesthesiology Physician (207L00000X) |
United | 78195 | $333.92 | 1346619129 - BLANCA LOPEZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 78195 | $68.26 | 1548743271 - RACHEL POWELL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Nurse Practitioner (363L00000X) |
United | 78195 | $392.85 | 1295710218 - MICHAEL NIEDER | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Medicine Physician (207Q00000X) |
United | 78195 | $1061.95 | 1861479545 - MAURY REGIONAL HOSPITAL, MAURY REGIONAL MEDICAL CENTER | 626002623 - MAURY REGIONAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 78195 | $333.92 | 1851800676 - MICHELLE TACKETT | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 78195 | $68.26 | 1447599089 - KELLY TERRANOVA | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 78195 | $473.16 | 1962995746 - KELLY GETZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Emergency Medicine Physician (207P00000X) |
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 78195 vs. Other Nuclear Medicine Procedures Codes
The CPT 78195 code is part of the Radiology Procedures services used for Nuclear Medicine 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 78195 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.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 78195. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 78195 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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