Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 95251 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.
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
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Endocrinology Services |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 95 - Telemedicine - audio and video |
| Complexity Level | Low |
| Medicare Fee Schedule | $35.07 national non-facility rate (2026) · View Medicare rates for 95251 |
| Medicaid Fee Schedule | $28.795 median of the 8 states in the free preview · View Medicaid rates for 95251 |
National average reimbursement for CPT 95251 by major payers:
$46.41
$48.02
$50.71
$68.67
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 95251.
CPT 95251
5 of 25 sample ratesHigher to lower in this preview
Khadijah Bilal
Kelsey-Seybold Medical Group PLLC
$101.87Published rateSantiago Wer Arrivillaga
Summit Medical Group, P.A.
$75.30Published rateMichael Gironta
Primary Care Partners, LLC
$63.45Published rateEastern Vascular LLC
Primary Care Partners, LLC
$61.61Published rateDeepinder Arora
Navesink Primary Careinc
$26.71Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 95251 vs. Other Endocrinology Services Codes
The CPT 95251 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 95251 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 95251. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95251 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 95251) and we'll show you how you compare in 15 minutes or less.