CPT 95018 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 • 59 - Distinct Procedural Service • 76 - Repeat procedure by same physician |
| Complexity Level | Low |
National average reimbursement for CPT 95018 by major payers:
$25.38
$26.95
$27.12
$38.96
| 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 95018 | ||||||
United | 95018 | $13.92 | 1376063370 - ABBY FREDRICKSON | 910844563 | MN | Psychiatry Physician (2084P0800X) |
United | 95018 | $9.18 | 1518124932 - RITU TALWAR | 363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLC | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $34.90 | 1205831393 - PRITI SINGH | 461302245 - (IL) ASSOCIATES IN PEDIATRIC NEUROLOGY SC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95018 | $70.25 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | FL | Psychiatry Physician (2084P0800X) |
United | 95018 | $27.19 | 1477181071 - KEVIN VARGHESE | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $25.20 | 1679968697 - JEREMIAH BREWER | 910843135 | WI | Psychiatry Physician (2084P0800X) |
United | 95018 | $30.20 | 1205054608 - SHITAL MEHTA | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $83.43 | 1568752665 - ANDREW KNOX | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95018 | $31.03 | 1437492493 - ASHLEY MULVIHILL | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95018 | $21.53 | 1215194519 - MATHERS CLINIC, LLC | 300626803 - (IL) MATHERS CLINIC LLC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95018 | $26.13 | 1578555256 - VIKTORIA ERHARDT | 363317058 - (IL) ACCESS COMMUNITY HEALTH NETWORK | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $32.20 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $33.16 | 1730207820 - KELLI KELLER | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $36.90 | 1841721925 - CHELSEA CURRY | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95018 | $40.22 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | PA | 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 95018 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95018 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 95018 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 95018. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95018 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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