CPT 95720 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 76 - Repeat procedure by same physician |
| Complexity Level | Moderate |
National average reimbursement for CPT 95720 by major payers:
$260.30
$275.12
$282.29
$343.08
| 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 95720 | ||||||
United | 95720 | $189.05 | 1396265708 - KIDNEY CARE OF MORRIS COUNTY LLC | 821835221 - KIDNEY CARE OF MORRIS COUNTY | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $166.31 | 1699734152 - PULMONARY & MEDICAL ASSOCIATES OF PASCACK VALLEY | 222840963 - PULMONARY MEDICAL ASSOCIATES OF PASCACK VALLEY | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $204.48 | 1952726796 - KENNEDY MEDICAL GROUP PRACTICE, P.C. | 461420853 - KENNEDY MEDICAL GROUP PRACTICE PC | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $207.79 | 1841564564 - ST. LUKE'S WARREN PHYSICIAN GROUP, PC | 223837316 - WARREN HEALTH CARE ALLIANCE, PC | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $835.12 | 1922459163 - MSK MONMOUTH | 300937486 | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $157.54 | 1922664259 - MEDICOR LIFESTYLE MEDICINE, P.A | 831257792 - MEDICOR LIFESTYLE MEDICINE PA | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $408.21 | 1902816507 - UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC | 222095812 - UNIVERSITY PHYSICIAN ASSOCIATES OF NEW JERSEY INC | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $163.65 | 1467641175 - EASTERN SURGICAL ASSOCIATES | 222276634 - EASTERN SURGICAL ASSOCIATES, PA | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $693.25 | 1184637886 - MEMORIAL SLOAN KETTERING CANCER CENTER AT BASKING RIDGE NEW JERSEY | 593801080 | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $176.62 | 1205189941 - TRINITAS PHYSICIANS PRACTICE, LLC | 460961495 | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $188.86 | 1740536903 - SPINE INSTITUTE OF NORTH AMERICA LLC | 454548380 - SPINE INSTITUTE OF NORTH AMERICA | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $214.92 | 1841512464 - ENDOCRINOLOGY ASSOCIATES OF PRINCETON, LLC | 271960284 - ENDOCRINOLOGY ASSOCIATES OF PRINCETON, LLC | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $223.58 | 1902944416 - SHORE HEALTH GROUP, PC | 223360408 - SHORE HEALTH GROUP, P.C. | NJ | Multi-Specialty Group (193200000X) |
United | 95720 | $176.96 | 1861590978 - MEETINGHOUSE FAMILY PHYSICIANS PA | 223759962 - MEETINGHOUSE FAMILY PHYSICIANS PA | NJ | Family Medicine Physician (207Q00000X) |
United | 95720 | $173.16 | 1841856218 - ETHOS WELLNESS | 833284202 - ETHOS WELLNESS | NJ | Multi-Specialty Group (193200000X) |
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 95720 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95720 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 95720 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 |
|---|---|---|
| 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) |
| 95719-CPT | Moderate | Electroencephalogram (Eeg) Continuous Recording Physician Or Other Qualified Health Care Professional Review Of Recorded Events Analysis Of Spike And Seizure Detection Each Increment Of Greater Than 12 Hours Up To 26 Hours Of Eeg Recording Interpretation And Report After Each 24-Hour Period; Without Video |
| 95720-CPT | Moderate | Electroencephalogram (Eeg) Continuous Recording Physician Or Other Qualified Health Care Professional Review Of Recorded Events Analysis Of Spike And Seizure Detection Each Increment Of Greater Than 12 Hours Up To 26 Hours Of Eeg Recording Interpretation And Report After Each 24-Hour Period; With Video (Veeg) |
| 95721-CPT | Moderate | Electroencephalogram (Eeg) Continuous Recording Physician Or Other Qualified Health Care Professional Review Of Recorded Events Analysis Of Spike And Seizure Detection Interpretation And Summary Report Complete Study; Greater Than 36 Hours Up To 60 Hours Of Eeg Recording Without Video |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95720. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95720 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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