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See a sample rate comparisonCPT 95060 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.
Ophthalmic Mucous Membrane Tests
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Allergy and Clinical Immunology Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | RT - Right side of body LT - Left side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | $40.75 national non-facility rate (2026) · View Medicare rates for 95060 |
| Medicaid Fee Schedule | $32.73 median of the 8 states in the free preview · View Medicaid rates for 95060 |
National average reimbursement for CPT 95060 by major payers:
$50.25
$38.87
$39.79
$48.80
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CPT 95060
5 of 25 sample ratesHigher to lower in this preview
Adam Wallace
Aurora Medical Group Inc
$120.52Published rateVinod Alluri
Loyola University Medical Center
$67.61Published rateLubov Romantseva
Rush University Medical Center
$64.75Published rateMohammed Ali
$58.79Published rateOfelia Ionescu
Ofelia Martha Ionescu Ltd
$27.95Published rate
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See a sample payer proposalCPT 95060 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95060 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 95060 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 95060. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95060 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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