CPT 84295 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 | Chemistry Procedures Pathology and Laboratory Procedures |
| Common Place of Service | 81 - Independent Laboratory 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component 91 - Repeat Lab Test |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 84295 |
National average reimbursement for CPT 84295 by major payers:
$3.70
$3.42
$5.77
$7.30
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 84295 | $2.75 | 1174526529 - TITUS COUNTY HOSPITAL DISTRICT, TITUS REGIONAL MEDICAL CENTER | 756003935 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.32 | 1134222565 - LAFAYETTE SURGICAL HOSPITAL LLC, LAFAYETTE SURGICAL SPECIALTY HOSPITAL | 900021727 - (LA) LAFAYETTE SURGICAL SPECIALTY HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 84295 | $5.90 | 1831183748 - HOMER MEMORIAL HOSPITAL, CLAIBORNE MEMORIAL MEDICAL CENTER | 720396868 - (LA) HOMER MEMORIAL HOSPITAL | LA | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.32 | 1487639175 - KNOX COUNTY HOSPITAL DISTRICT, KNOX COUNTY HOSPITAL DISTRICT | 750808798 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.80 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.80 | 1891873337 - CLHG, MINDEN MEDICAL CENTER | 824625698 | LA | Rural Acute Care Hospital (282NR1301X) |
United | 84295 | $4.80 | 1700885076 - TH HEALTHCARE, LTD, NACOGDOCHES MEDICAL CENTER | 760354630 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.80 | 1609275585 - CHCA PEARLAND, L.P., HCA HOUSTON HEALTHCARE PEARLAND | 50631189 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.09 | 1235685892 - FAIRFIELD HOSPITAL DISTRICT, FREESTONE MEDICAL CENTER | 741774669 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $4.80 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $2.81 | 1457358103 - BELLVILLE HOSPITAL DISTRICT, BELLVILLE GENERAL HOSPITAL | 274005511 - BELLVILLE MEDICAL CENTER | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $2.75 | 1407191984 - BSA HOSPITAL LLC | 900914340 | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $2.01 | 1427410240 - BRANDON OKEEFE RAFAELI | 760459500 - U T PHYSICIANS | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $2.49 | 1295736734 - CHRISTUS HEALTH ARK-LA-TEX, CHRISTUS ST. MICHAEL HEALTH SYSTEM | 752796815 - CHRISTUS HEALTH ARK-LA-TEX | TX | General Acute Care Hospital (282N00000X) |
United | 84295 | $80.00 | 1366428401 - AARON ASKEW | 931224010 - PRAXIS HEALTH, P.C. | OR | Orthopaedic Trauma Physician (207XX0801X) |
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 84295 vs. Other Pathology and Laboratory Procedures Codes
The CPT 84295 code is part of the Chemistry Procedures services used for Pathology and Laboratory 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 84295 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 |
|---|---|---|
| 84295-CPT | Low | Sodium Electrolyte Test, Sodium Is An Electrolyte Helping The Body Stay Hydrated. The Blood Test Determines Fluid Retention Or Dehydration. The Urine Test Detects Too Much Or Too Little Sodium. The Tests Help Monitor High Blood Pressure And Kidney Function. |
| 84300-CPT | Low | Sodium Electrolyte Test, Sodium Is An Electrolyte Helping The Body Stay Hydrated. The Blood Test Determines Fluid Retention Or Dehydration. The Urine Test Detects Too Much Or Too Little Sodium. The Tests Help Monitor High Blood Pressure And Kidney Function. |
| 84307-CPT | Low | Somatostatin Plasma Test, This Test Measures Somatostatin A Hormone Found In The Brain And Secreted By Digestive Organs. Its Purpose Is To Slow Stop Or Limit The Action Of Growth Hormone The Digestive Process And Production Of Insulin And Glucose. |
| 84311-CPT | Low | Lab Analysis With Light Waves, Spectrophotometry Is A Testing Method That Examines Visible Ultraviolet And Infrared Light Waves Shone Onto A Body Fluid Sample. The Method Measures The Amount Of Light Absorbed By The Sample. Results Indicate Density Of A Material In The Fluid. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 84295. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 84295 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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