CPT 95819 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 • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 95819 by major payers:
$481.96
$476.78
$547.13
$655.69
| 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 95819 | ||||||
United | 95819 | $556.28 | 1417078890 - BRIAN KEYES | 391157876 | IN | Orthopaedic Surgery Physician (207X00000X) |
United | 95819 | $401.86 | 1508829409 - RICHARD BASSI | 351747218 | GA | Anesthesiologist Assistant (367H00000X) |
United | 95819 | $66.58 | 1942407838 - MARK NIELSON | 351728855 | IN | Anesthesiology Physician (207L00000X) |
United | 95819 | $472.77 | 1104821974 - JENNIFER PETERSEN-GOLDSPIEL | 351913875 | IN | Cardiovascular Disease Physician (207RC0000X) |
United | 95819 | $66.58 | 1942457072 - ANTHONY YANG | 202981280 | IN | Surgery Physician (208600000X) |
United | 95819 | $809.39 | 1285645531 - DMITRIY TCKACHENKO | 901116751 | IN | Anesthesiology Physician (207L00000X) |
United | 95819 | $472.77 | 1720269251 - WILLIAM BELL | 237427350 | IN | Anatomic Pathology Physician (207ZP0101X) |
United | 95819 | $69.26 | 1821099946 - RONALD BURWINKEL | 351789998 | IN | Pulmonary Disease Physician (207RP1001X) |
United | 95819 | $401.86 | 1063820637 - ZACHARY ADAMS | 351747218 | IN | Clinical Psychologist (103TC0700X) |
United | 95819 | $90.16 | 1386273936 - HARSH SHAH | 592898487 | FL | Emergency Medicine Physician (207P00000X) |
United | 95819 | $79.08 | 1265482988 - KISHIN DODWANI | 273645560 | KY | Anesthesiology Physician (207L00000X) |
United | 95819 | $806.79 | 1417988270 - ALEXANDER CHOI | 742979291 | IN | Anesthesiology Physician (207L00000X) |
United | 95819 | $472.77 | 1205254711 - ROBERT TYSKLIND | 43666805 | IN | Orthopaedic Surgery Physician (207X00000X) |
United | 95819 | $584.25 | 1780213926 - JOHN PEACOCK | 571004971 | IN | Emergency Medicine Physician (207P00000X) |
United | 95819 | $401.86 | 1952968711 - ALLISON MEYER | 351747218 | IN | Clinical Child & Adolescent Psychologist (103TC2200X) |
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 95819 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95819 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 95819 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 |
|---|---|---|
| 95712-CPT | Moderate | Electroencephalogram With Video (Veeg) Review Of Data Technical Description By Eeg Technologist 2-12 Hours; With Intermittent Monitoring And Maintenance |
| 95714-CPT | Moderate | Electroencephalogram With Video (Veeg) Review Of Data Technical Description By Eeg Technologist Each Increment Of 12-26 Hours; Unmonitored |
| 95812-CPT | Moderate | Electroencephalogram (Eeg) Extended Monitoring; Up To One Hour |
| 95819-CPT | Moderate | Electroencephalogram (Eeg) Including Recording Awake And Asleep (Including Hyperventilation And/Or Photic Stimulation When Appropriate) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95819. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95819 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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