CPT 95810 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 95810 by major payers:
$654.98
$843.74
$902.86
$1,094.77
| 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 95810 | ||||||
United | 95810 | $1435.26 | 1144582180 - MICHAEL SMITH | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | NY | Trauma Surgery Physician (2086S0127X) |
United | 95810 | $1175.06 | 1508867789 - ROBERT FALLIS | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Psychiatry Physician (2084P0800X) |
United | 95810 | $366.67 | 1497868848 - GARY WENDELL | 462460290 | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $1109.78 | 1346467172 - ASHLEE PIERCEY | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Acute Care Nurse Practitioner (363LA2100X) |
United | 95810 | $563.48 | 1417945460 - JOHN TRAVALINE | 232791952 - (PA) SEGAL AARONSON PULMONARY ASSOCIATES PC | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $1175.06 | 1649511585 - KRISTOPHER HASSTEDT | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Oral and Maxillofacial Surgery (Dentist) (1223S0112X) |
United | 95810 | $983.32 | 1366978256 - STELLA SAVARIMUTHU | 166116449 | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $1268.18 | 1669030607 - HEATHER GRIFFIN | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Physician Assistant (363A00000X) |
United | 95810 | $261.51 | 1649407628 - MARC GAUTHIER | 232919472 - UPMC | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $93.06 | 1225325095 - RAHUL MEHTA | 223837316 - WARREN HEALTH CARE ALLIANCE, PC | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $684.55 | 1396937264 - RUPAL SHAH | 943281660 | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $316.91 | 1417301573 - AMANDA LYNALL | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Emergency Medical Services (Emergency Medicine) Physician (207PE0004X) |
United | 95810 | $1109.78 | 1073886164 - EMILY NARDONE | 352528741 - VANDERBILT UNIVERSITY MEDICAL CENTER | TN | Family Nurse Practitioner (363LF0000X) |
United | 95810 | $895.88 | 1598055014 - OMAIR CHAUDHARY | 232730785 - WELLSPAN MEDICAL GROUP | PA | Pulmonary Disease Physician (207RP1001X) |
United | 95810 | $650.96 | 1184824484 - SAEHER MUZAFFAR | 943281657 | PA | Pulmonary Disease Physician (207RP1001X) |
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 95810 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95810 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 95810 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 |
|---|---|---|
| 95782-CPT | High | Polysomnography; Younger Than 6 Years Sleep Staging With 4 Or More Additional Parameters Of Sleep Attended By A Technologist |
| 95783-CPT | High | Polysomnography; Younger Than 6 Years Sleep Staging With 4 Or More Additional Parameters Of Sleep With Initiation Of Continuous Positive Airway Pressure Therapy Or Bi-Level Ventilation Attended By A Technologist |
| 95806-CPT | Low | Sleep Study, Unattended, Simultaneous Recording Of, Heart Rate, Oxygen Saturation, Respiratory Airflow, And Respiratory Effort (Eg, Thoracoabdominal Movement) |
| 95810-CPT | Moderate | Polysomnography; Age 6 Years Or Older Sleep With 4 Or More Additional Parameters Of Sleep Attended By A Technologist (Revised 1/1/2013) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95810. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95810 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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