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See a sample rate comparisonCPT 95199 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.
Unlisted Allergyclinical Immu, Unlisted Allergyclinical Immunologic Service Or Procedureunlisted Allergyclinical Immunologic Service Or Procedure
| 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 GA - Required ABN issued and on file |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 95199 |
| Medicaid Fee Schedule | $33.175 median of the 2 states in the free preview · View Medicaid rates for 95199 |
National average reimbursement for CPT 95199 by major payers:
$670.74
$174.66
$67.77
$291.22
Compare published rates across providers.
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CPT 95199
5 of 25 sample ratesHigher to lower in this preview
Medstar Georgetown Medical Center, Inc, Georgetown University Hospital Physicians
Medstar-Georgetown Medical Center Inc
$101.47Published rateWomens Center Of Northwest Arkansas LLC, Willow Creek Women'S Hospital
$72.05Published rateNicholas H. Noyes Memorial Hospital
Nicholas H Noyes Memorial Hospital
$59.34Published rateNorthwest Miss Regional Medical Center, Northwest Mississippi Regional Medical Center
$42.58Published rateSouthwest Mississippi Regional Medical Center, Lawrence County Hospital
$28.02Published rate
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See a sample payer proposalCPT 95199 vs. Other Allergy and Clinical Immunology Procedures Codes
The CPT 95199 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 95199 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 |
|---|---|---|
| 95144-CPT | Low | Professional Services For The, Professional Services For The Supervision And Provision Ofantigens For Allergen Immunotherapy Single Or Multiple Antigens Single Dose Vials (Specify Number Of Vials) |
| 95145-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy (Specify Number Of Doses); Single Stinging Insect Venom |
| 95146-CPT | Low | Antigen Therapy Services, Professional Services For The Supervision Of Preparation And Provision Of Antigens For Allergen Immunotherapy (Specify Number Of Doses); Two Single Stinging Insect Venoms |
| 95199-CPT | Moderate | Unlisted Allergyclinical Immu, Unlisted Allergyclinical Immunologic Service Or Procedureunlisted Allergyclinical Immunologic Service Or Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95199. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95199 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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