CPT 95709 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Neurology and Neuromuscular Procedures |
| Common Place of Service | • 11 - Office • 15 - Mobile Unit |
| Common Modifiers | • None • TC - Technical component • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 95709 by major payers:
$793.23
$880.53
$819.17
$1,271.38
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 95709 | ||||||
United | 95709 | $647.09 | 1275564197 - PAUL BERKOWITZ | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | FL | Psychiatry Physician (2084P0800X) |
United | 95709 | $727.34 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 95709 | $1193.30 | 1932216702 - ANAND KUMAR | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $1529.56 | 1295769297 - YOLANDA HOLLER-MANAGAN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95709 | $762.84 | 1407807746 - SYED KHAN | 320552496 | IN | Psychiatry Physician (2084P0800X) |
United | 95709 | $610.60 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | AZ | Psychiatry Physician (2084P0800X) |
United | 95709 | $897.90 | 1023112745 - NELDA AKINBILE | 860285857 - EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER INC | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $668.96 | 1366540072 - DHRUV PATEDER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 95709 | $890.58 | 1528695681 - MAYA CLOYD | 351913875 - INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS | IN | Psychiatry Physician (2084P0800X) |
United | 95709 | $1231.11 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $727.34 | 1306340880 - GEORGE GIANAKAKOS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | FL | Psychiatry Physician (2084P0800X) |
United | 95709 | $788.53 | 1700226206 - ALIESJE SORGELOOS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95709 | $731.28 | 1487755955 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 95709 | $946.25 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | MN | Psychiatry Physician (2084P0800X) |
United | 95709 | $1650.94 | 1992122410 - DIVAKAR MITHAL | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 95709 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95709 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular 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 95709 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 |
|---|---|---|
| 95709-CPT | Moderate | Electroencephalogram (Eeg) Without Video Review Of Data Technical Description By Eeg Technologist Each Increment Of 12-26 Hours; With Intermittent Monitoring And Maintenance |
| 95710-CPT | Moderate | Electroencephalogram (Eeg) Without Video Review Of Data Technical Description By Eeg Technologist Each Increment Of 12-26 Hours; With Continuous Real-Time Monitoring And Maintenance |
| 95717-CPT | Low | Electroencephalogram (Eeg), Continuous Recording, Physician Or Other Qualified Health Care Professional Review Of Recorded Events, Analysis Of Spike And Seizure Detection, Interpretation And Report, 2-12 Hours Of Eeg Recording; Without Video |
| 95718-CPT | Low | Electroencephalogram (Eeg), Continuous Recording, Physician Or Other Qualified Health Care Professional Review Of Recorded Events, Analysis Of Spike And Seizure Detection, Interpretation And Report, 2-12 Hours Of Eeg Recording; With Video (Veeg) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95709. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95709 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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