CPT 95852 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 | Range of Motion Testing Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None GO - Services delivered under an outpatient occupational therapy plan of care 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95852 |
National average reimbursement for CPT 95852 by major payers:
$20.41
$21.84
$21.33
$27.09
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 95852 | $49.57 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 95852 | $34.13 | 1275767386 - ERIN ZAHRADNIK | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $32.02 | 1700131182 - MATTHEW ATIENZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $35.36 | 1730246067 - SENADA BAJMAKOVIC-KACILA | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $36.91 | 1376063370 - ABBY FREDRICKSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MN | Psychiatry Physician (2084P0800X) |
United | 95852 | $36.29 | 1760412621 - RHONDA LAMPEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MI | Psychiatry Physician (2084P0800X) |
United | 95852 | $32.02 | 1609039163 - HUMA ABBAS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $36.29 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $36.13 | 1295791812 - LEON EPSTEIN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95852 | $36.29 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | GA | Psychiatry Physician (2084P0800X) |
United | 95852 | $18.40 | 1588012058 - ALEXANDRIA MELENDEZ-ZAIDI | 752668018 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95852 | $20.06 | 1679845531 - DANA HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | 95852 | $36.29 | 1407807746 - SYED KHAN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IN | Psychiatry Physician (2084P0800X) |
United | 95852 | $32.02 | 1992961643 - CYNTHIA GORDON | 815174138 - (IL) ILLINOIS PROFESSIONALS HEALTH PROGR | IL | Psychiatry Physician (2084P0800X) |
United | 95852 | $39.83 | 1710061486 - DAVID KEMP | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
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 95852 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95852 code is part of the Range of Motion Testing 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 95852 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 |
|---|---|---|
| 95851-CPT | Low | Range Of Motion Test Joint, Exam To Measure The Range Of Motion In Various Joints (How Far One Can Bend Or Straighten The Joints) And Compare The Measurements To Normal Values. Exam Includes Interpretation Of Results. |
| 95852-CPT | Low | Range Of Motion Measurements, Range Of Motion Measurements And Report Separate Procedure Hand With Or Without Comparison With Normal Side |
| 95860-CPT | Low | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
| 95861-CPT | Low | Test Nerve In Arm Leg Muscles, An Electromyography (Emg) Measures How Muscles Respond To Nerve Impulses. An Electrode Attached To A Needle Is Inserted Into One Extremity (Arm Leg Hand Foot Or Neck Muscles). Related Muscles Along The Spine May Be Tested As Well. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95852. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95852 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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