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See a sample rate comparisonCPT 95070 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.
Inhalation Bronchial Challenge, Inhalation Bronchial Challenge Testing (Not Including Necessary Pulmonary Function Tests) With Histamine Methacholine Or Similar Compounds
| 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 | 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $39.75 national non-facility rate (2026) · View Medicare rates for 95070 |
| Medicaid Fee Schedule | $32.745 median of the 8 states in the free preview · View Medicaid rates for 95070 |
National average reimbursement for CPT 95070 by major payers:
$48.02
$50.18
$47.31
$57.09
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CPT 95070
5 of 25 sample ratesHigher to lower in this preview
Rhonda Lampen
Multicare Health System
$99.04Published rateMatthew Niedzwiecki
$64.72Published rateGaurav Yadava
Rita Yadava Mdsc
$57.79Published rateNelda Akinbile
Veterans Assistance Commission C
$40.13Published rateOyoyo Sawyer
District Medical Group Inc
$26.96Published rate
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See a sample payer proposalCPT 95070 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95070 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 95070 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 |
|---|---|---|
| 95012-CPT | Low | Nitric Oxide Expired Gas Determination |
| 95070-CPT | Low | Inhalation Bronchial Challenge, Inhalation Bronchial Challenge Testing (Not Including Necessary Pulmonary Function Tests) With Histamine Methacholine Or Similar Compounds |
| 95076-CPT | Low | Ingest Challenge Ini 120 Min, Ingestion Challenge Test Sequential And Incremental Ingestion Of Test Items Eg Food Drug Or Other Substance Initial 120 Minutes Of Testing |
| 95079-CPT | Low | Ingest Challenge Addl 60 Min, Ingestion Challenge Test Sequential And Incremental Ingestion Of Test Items Eg Food Drug Or Other Substance Each Additional 60 Minutes Of Testing List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95070. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95070 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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