CPT 95017 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 • Allergy and Clinical Immunology Procedures |
| Common Place of Service | • 11 - Office • 19 - Off Campus Outpatient Hospital |
| Common Modifiers | • None • 76 - Repeat procedure by same physician • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 95017 by major payers:
$18.58
$10.84
$11.04
$21.16
| 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 95017 | ||||||
United | 95017 | $15.97 | 1679540595 - JOSEPH MCNALLY | 461186809 - (IL) MCNALLY AND GARA PSYCHIATRIC SOLUTIONS LLC | IL | Psychiatry Physician (2084P0800X) |
United | 95017 | $14.28 | 1629181037 - DUKE RUKTANONCHAI | 742958277 - SCOTT & WHITE CLINIC | PA | Psychiatry Physician (2084P0800X) |
United | 95017 | $21.40 | 1720582422 - DELANEY DOWD | 756002868 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $16.55 | 1356608988 - TRIXIE LIPKE | 391157876 - BEAVER DAM COMMUNITY HOSPITALS INC | WI | Psychiatry Physician (2084P0800X) |
United | 95017 | $18.18 | 1043252521 - DENIS ALTMAN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $14.22 | 1184815870 - RYAN COATES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $13.72 | 1568752665 - ANDREW KNOX | 362222696 - SWEDISHAMERICAN HOSPITAL | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $14.82 | 1508922964 - COLLEEN BUHRFIEND | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $18.50 | 1225211600 - JOHN MILLICHAP | 753186720 | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95017 | $16.40 | 1174859284 - MATTHEW NIEDZWIECKI | 811324691 | RI | Psychiatry Physician (2084P0800X) |
United | 95017 | $14.82 | 1477670461 - LOUIS KRAUS | 911780160 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95017 | $14.50 | 1225285703 - ANDREI PANKOV | 320552496 | IL | Psychiatry Physician (2084P0800X) |
United | 95017 | $12.06 | 1073697132 - FEDRA NAJJAR | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95017 | $13.81 | 1366883555 - DAVID BANAYAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 95017 | $16.67 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | 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 95017 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95017 code is part of the Medicine Services and Procedures services used for Allergy and Clinical Immunology 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 95017 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 |
|---|---|---|
| 95004-CPT | Low | Percutaneous Tests (Scratch Puncture Prick) Withallergenic Extracts Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Tests (Revised 01/01/13) |
| 95017-CPT | Low | Allergy Testing Any Combination Of Percutaneous (Scratch Puncture Prick) And Intracutaneous (Intradermal) Sequential And Incremental With Venoms Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Tests(Reinstated) Sensitivity Skin Tests 11-15 (Intradermal) (Old Description Deleted 03/31/2003) |
| 95018-CPT | Low | Allergy Testing Any Combination Of Percutaneous (Scratch Puncture Prick) And Intracutaneous (Intradermal) Sequential And Incremental With Drugs Or Biologicals Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Tests (Reinstated) Sensitivity Skin Tests 15+ (Intradermal) (Old Description Deleted 03/31/2003) |
| 95024-CPT | Low | Intracutaneous (Intradermal) Tests With Allergenicextracts Immediate Type Reaction Including Test Interpretation And Report Specify Number Of Test (Revised 01/01/13) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95017. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95017 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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