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See a sample rate comparisonCPT 95052 Fee Schedule
Last Verified: October 2026
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.
Photo Patch Test(S) (Specify N, Photo Patch Test(S) (Specify Number Of Tests)Photopatch Test(S) (Specify Number Of Tests)
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Allergy and Clinical Immunology Procedures |
| Common Place of Service | 11 - Office 20 - Urgent Care Facility 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service GC - Service performed by resident under supervision |
| Complexity Level | Low |
| Medicare Fee Schedule | $6.01 national non-facility rate (2026) · View Medicare rates for 95052 |
| Medicaid Fee Schedule | $4.945 median of the 8 states in the free preview · View Medicaid rates for 95052 |
National average reimbursement for CPT 95052 by major payers:
$8.80
$8.64
$8.06
$9.66
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CPT 95052
5 of 25 sample ratesHigher to lower in this preview
Trilok Shah
Ascension Medical Group-Fox Valley Wisconsin Inc
$20.56Published rateJocelyn Lorenzo
$11.27Published rateColleen Buhrfiend
Veterans Assistance Commission C
$8.63Published rateJohn Buttari
Town Center Orthopaedic Associates, P.C.
$7.00Published rateCamilla Grant
Town Center Orthopaedic Associates, P.C.
$5.76Published rate
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See a sample payer proposalCPT 95052 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95052 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 95052 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 | Allergy Skin Tests, Test For Allergies To Pollen Animal Dander Drugs Or Other Substances. The Test Is Performed By Placing A Small Amount Of The Suspected Allergen Under The Skin And Monitoring To See If A Reaction Occurs. |
| 95024-CPT | Low | Allergy Skin Tests, Test For Allergies To Pollen Animal Dander Drugs Or Other Substances. The Test Is Performed By Placing A Small Amount Of The Suspected Allergen Under The Skin And Monitoring To See If A Reaction Occurs. |
| 95044-CPT | Low | Patch Or Application Test(S) (, Patch Or Application Test(S) (Specify Number Of Tests)Patch Or Application Test(S) (Specify Number Of Tests) |
| 95052-CPT | Low | Photo Patch Test(S) (Specify N, Photo Patch Test(S) (Specify Number Of Tests)Photopatch Test(S) (Specify Number Of Tests) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95052. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95052 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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