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CPT 95065 Fee Schedule

Last Verified: November 2025

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.

Direct Nasal Mucous Membrane Test
Key FactDetail
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

XS - Separate Structure

50 - Bilateral Procedure

Complexity LevelLow

National average reimbursement for CPT 95065 by major payers:

bcbs

$36.59

uhc

$29.16

aetna

$29.36

cigna

$37.08

Preview provider-level rates for...
For billing codeCPT 95065
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 95065

United
95065$41.131568533701 - REGINALD GIVENS362222696 - SWEDISHAMERICAN HOSPITALILPsychiatry Physician (2084P0800X)
United
95065$50.001366890857 - STEVEN SHARP364015560 - LOYOLA UNIVERSITY MEDICAL CENTERILPsychiatry Physician (2084P0800X)
United
95065$44.471952569758 - CHARLES HEBERT911780160COPsychiatry Physician (2084P0800X)
United
95065$47.881508986308 - COREY GOLDSTEIN911780160ILPsychiatry Physician (2084P0800X)
United
95065$44.471376001701 - SAMANTHA PATEL911780160ILPsychiatry Physician (2084P0800X)
United
95065$49.701669524369 - JENNIFER KURTH205734385ILPsychiatry Physician (2084P0800X)
United
95065$37.841790181402 - SONAM VERMA611661781ILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
95065$37.061447365440 - AYAME TAKAHASHI364143823 - SIU PHYSICIANS & SURGEONS INCILChild & Adolescent Psychiatry Physician (2084P0804X)
United
95065$48.771619123114 - MARGARET MICHELSON363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATESILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
95065$49.701891921367 - KAVITA THAKKAR363279680 - (IL) PEDIATRIC FACULTY FOUNDATION INPANeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
95065$44.471811298987 - ROSARIO COSME CRUZ911780160ILChild & Adolescent Psychiatry Physician (2084P0804X)
United
95065$52.001205831393 - PRITI SINGH461302245 - (IL) ASSOCIATES IN PEDIATRIC NEUROLOGY SCILNeurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United
95065$44.201609023068 - LAURA MURPHY362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATIONILPsychiatry Physician (2084P0800X)
United
95065$42.631518124932 - RITU TALWAR363994258 - (IL) HORIZONS BEHAVIORAL HEALTH LLCILPsychiatry Physician (2084P0800X)
United
95065$33.221316142383 - DIANE MISCH376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOISILPsychiatry Physician (2084P0800X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 95065 vs. Other Allergy and Clinical Immunology Procedures Codes

The CPT 95065 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 95065 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.

CodeComplexityDescription
95052-CPTLowPhoto Patch Tests
95056-CPTLowPhoto Tests
95060-CPTLowOphthalmic Mucous Membrane Tests
95065-CPTLowDirect Nasal Mucous Membrane Test

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95065. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 95065 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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