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See a sample rate comparisonCPT 95249 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.
Ambulatory Continuous Glucose, Ambulatory Continuous Glucose Monitoring Of Interstitial Tissue Fluid Via A Subcutaneous Sensor For A Minimum Of 72 Hours Patient-Provided Equipmentsensor Placement Hook-Up Calibration Of Monitor Patient Training And Printout Of Recording Tional Test(S) When Performed
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Endocrinology Services |
| Common Place of Service | 11 - Office 50 - Federally Qualified Health Center |
| Common Modifiers | 59 - Distinct Procedural Service PO - Services, procedures and/or surgeries furnished at off-campus provider-based outpatient departments |
| Complexity Level | Low |
| Medicare Fee Schedule | $69.81 national non-facility rate (2026) · View Medicare rates for 95249 |
| Medicaid Fee Schedule | $56.735 median of the 8 states in the free preview · View Medicaid rates for 95249 |
National average reimbursement for CPT 95249 by major payers:
$77.69
$71.69
$76.12
$106.50
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CPT 95249
5 of 25 sample ratesHigher to lower in this preview
Elizabeth Patberg
$400.19Published rateJeanette Carpenter
Obstetrix Medical Group Of Utah PC
$110.59Published rateWhitney You
Advocate Health And Hospitals Corporation
$89.25Published rateLancaster General Hospital, Penn Medicine Lghp Maternal-Fetal Medicine
Wellspan Medical Group
$76.65Published rateMichelle Kominiarek
Humboldt Park Health
$59.42Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 95249 vs. Other Endocrinology Services Codes
The CPT 95249 code is part of the Medicine Services and Procedures services used for Endocrinology Services. 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 95249 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 |
|---|---|---|
| 95249-CPT | Low | Ambulatory Continuous Glucose, Ambulatory Continuous Glucose Monitoring Of Interstitial Tissue Fluid Via A Subcutaneous Sensor For A Minimum Of 72 Hours Patient-Provided Equipmentsensor Placement Hook-Up Calibration Of Monitor Patient Training And Printout Of Recording Tional Test(S) When Performed |
| 95250-CPT | Low | Ambulatory Continous Glucose Monitoring Of Intersitial Tissue Fluid Via A Subcutaneous Sensor For A Minimum Of 72 Hours; Physician Or Other Qualified Health Care Professional (Office) Provided Equipment Sensor Placement Hook-Up Calibration Of Monitor Patient Training Removal Of Sensor And Printout Of Recording (Desc Revised 1/1/2018) |
| 95251-CPT | Low | Diagnostic Test, Ambulatory Continuous Glucose Monitoring Of Interstitial Tissue Fluid Via A Subcutaneous Sensor For A Minimum Of 72 Hours; Physician Or Other Qualified Health Care Professional (Office) Provided Equipment Sensor Placement Hook-Up Calibration Of Monitor Patient Training Removal Of Sensor And Printout Of Recording Interpretation And Report |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95249. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95249 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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