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See a sample rate comparisonCPT 95165 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.
Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy; Single Or Multiple Antigens (Specify Number Of Doses)
| 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 | 76 - Repeat procedure by same physician 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $17.37 national non-facility rate (2026) · View Medicare rates for 95165 |
| Medicaid Fee Schedule | $13.10 median of the 8 states in the free preview · View Medicaid rates for 95165 |
National average reimbursement for CPT 95165 by major payers:
$15.95
$16.52
$18.07
$20.14
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CPT 95165
5 of 25 sample ratesHigher to lower in this preview
Stephen Chorney
$36.59Published rateTexas Tech University Health Sciences Center Lubbock, Ttuhsc-Allergy
$15.93Published rateWilliam Murray
Amarillo Bone Joint Clinic PLLC
$14.50Published rateBarry Paull
Allergy Associates Of Brazos Valley
$12.57Published rateMauricio Ruiz
Laredo Sport Medicine Clinic, PA
$9.61Published rate
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See a sample payer proposalCPT 95165 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95165 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 95165 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 |
| 95165-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy; Single Or Multiple Antigens (Specify Number Of Doses) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95165. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95165 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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