CPT 95711 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 • 21 - Inpatient Hospital |
| Common Modifiers | • None • TC - Technical component • 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
National average reimbursement for CPT 95711 by major payers:
$262.83
$206.87
$213.47
$310.69
| 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 95711 | ||||||
United | 95711 | $179.38 | 1043358781 - JOSEPH COOPER | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $152.25 | 1255692794 - MELISSA WAGNER-SCHUMAN | 311405915 | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $411.79 | 1194719534 - MARY BELFORD | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $229.91 | 1780976399 - ANNA JEONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95711 | $235.60 | 1700328788 - LIMITLESS MEDICAL GROUP, LTD | 933955099 | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $457.73 | 1952460933 - LARISSA CHISM BUGGS | 810231784 - BILLINGS CLINIC | IN | Psychiatry Physician (2084P0800X) |
United | 95711 | $468.48 | 1679526784 - ELTON SMITH | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $397.10 | 1063471159 - MARK WAINWRIGHT | 911336707 - THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95711 | $379.08 | 1114196995 - ANGELA GREEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | LA | Psychiatry Physician (2084P0800X) |
United | 95711 | $284.70 | 1528695681 - MAYA CLOYD | 351913875 - INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS | IN | Psychiatry Physician (2084P0800X) |
United | 95711 | $396.48 | 1134236565 - WARREN KAMMERER | 611549647 - (IL) WARREN KAMMERER MD SC | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $468.48 | 1962664789 - JAMIE EVANS | 910844563 | VA | Psychiatry Physician (2084P0800X) |
United | 95711 | $279.79 | 1447264932 - CYNTHIA STACK | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95711 | $125.01 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 95711 | $139.69 | 1851558001 - LUBOV ROMANTSEVA | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | 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 95711 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95711 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 95711 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 |
| 95711-CPT | Moderate | Electroencephalogram With Video (Veeg) Review Of Data Technical Description By Eeg Technologist 2-12 Hours; Unmonitored |
| 95712-CPT | Moderate | Electroencephalogram With Video (Veeg) Review Of Data Technical Description By Eeg Technologist 2-12 Hours; With Intermittent Monitoring And Maintenance |
| 95713-CPT | Moderate | Electroencephalogram With Video (Veeg) Review Of Data Technical Description By Eeg Technologist 2-12 Hours; With Continuous Real-Time Monitoring And Maintenance |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95711. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95711 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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