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See a sample rate comparisonCPT 95120 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.
Immunotherapy One Injection, Professional Services For Allergen Immunotherapy In The Office Or Institution Of The Prescribing Physician Or Other Qualified Health Care Professional Including Provision Of Allergenic Extract Single Injection
| 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 | 51 - Multiple procedures GZ - Item or Service Expected to Be Denied as Not Reasonable and Necessary |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95120 |
| Medicaid Fee Schedule | $9.975 median of the 8 states in the free preview · View Medicaid rates for 95120 |
National average reimbursement for CPT 95120 by major payers:
$18.81
$15.14
$12.68
$217.95
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CPT 95120
5 of 25 sample ratesHigher to lower in this preview
Andrew Knox
Aurora Medical Group Inc
$32.20Published rateMatthew Niedzwiecki
Loyola University Medical Center
$21.00Published ratePeter Heydemann
$19.01Published rateHossam Abdelsalam
$15.76Published rateClint Anthony
District Medical Group Inc
$8.98Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 95120 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95120 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 95120 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 |
|---|---|---|
| 95115-CPT | Low | Professional Services For Alle, Professional Services For Allergen Immunotherapy Notincluding Provision Of Allergenic Extracts Single Injection |
| 95117-CPT | Low | Professional Services For Alle, Professional Services For Allergen Immunotherapy Notincluding Provision Of Allergenic Extracts Two Or More Injections |
| 95120-CPT | Low | Immunotherapy One Injection, Professional Services For Allergen Immunotherapy In The Office Or Institution Of The Prescribing Physician Or Other Qualified Health Care Professional Including Provision Of Allergenic Extract Single Injection |
| 95125-CPT | Low | Immunotherapy 2 Injections, Professional Services For Allergen Immunotherapy In The Office Or Institution Of The Prescribing Physician Or Other Qualified Health Care Professional Including Provision Of Allergenic Extract 2 Or More Injections |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95120. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95120 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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