CPT 95875 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 95875 |
National average reimbursement for CPT 95875 by major payers:
$150.34
$160.77
$157.41
$197.13
| 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 95875 | ||||||
United | 95875 | $107.73 | 1386085546 - SATINDER GREWAL | 61562701 - (NY) ST CATHERINE OF SIENA MEDICAL CENTER | FL | Neurology Physician (2084N0400X) |
United | 95875 | $75.29 | 1851368476 - DAVID HEI | 461243081 | FL | Medical Oncology Physician (207RX0202X) |
United | 95875 | $30.12 | 1760470934 - MARIANO CIBRAN | 591355883 - (FL) ST. PETERSBURG PEDIATRICS | FL | Pediatrics Physician (208000000X) |
United | 95875 | $131.41 | 1427023852 - IVAN ROSAS | 300791563 | TX | Pulmonary Disease Physician (207RP1001X) |
United | 95875 | $142.86 | 1922111657 - CLINT ANTHONY | 860830701 | AZ | Psychiatry Physician (2084P0800X) |
United | 95875 | $134.61 | 1992890537 - SHARON ORNSTEIN | 522389157 | TX | Oral & Maxillofacial Surgery (D.M.D.) (204E00000X) |
United | 95875 | $136.44 | 1851558001 - LUBOV ROMANTSEVA | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95875 | $146.19 | 1306052527 - ALEXANDER COLEMAN | 593366100 - NORTH FLORIDA SURGEONS, P.A. | FL | Orthopaedic Hand Surgery Physician (207XS0106X) |
United | 95875 | $78.05 | 1992140230 - YUMA SPINE & JOINT PLLC, KIMBER SPINE | 462548295 - (FL) YUMA SPINE JOINT PLLC | FL | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 95875 | $203.10 | 1336535004 - LAEL STIEGLITZ | 462620381 - (FL) BAPTIST MD ANDERSON CANCER PHYSICIANS INC | FL | Urology Physician (208800000X) |
United | 95875 | $55.24 | 1285724872 - ANTHONY CATINELLA | 752668018 | TX | Family Medicine Physician (207Q00000X) |
United | 95875 | $55.24 | 1285724872 - ANTHONY CATINELLA | 752668018 | TX | Family Medicine Physician (207Q00000X) |
United | 95875 | $106.30 | 1457319832 - DAVID HALSEY | 382887792 - DAVID L. HALSEY, MD | MI | Internal Medicine Physician (207R00000X) |
United | 95875 | $115.08 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 95875 | $231.25 | 1851768337 - KELLY RIDGES | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
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 95875 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95875 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 95875 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 |
|---|---|---|
| 95875-CPT | Low | Ischemic Limb Exercise Test With Serial Specimen(S) Acquisition For Muscle(S) Metabolite(S) (Desc Rev 01/01/03) |
| 95905-CPT | Low | Motor And/Or Sensory Nerve Conduction, Using Preconfigured Electrode Array(S), Amplitude And Latency/Velocity Study, Each Limb, Includes F-Wave Study When Performed, With Interpretation And Report |
| 95907-CPT | Low | Motor &/Sens 1-2 Nrv Cndj Preconf Eltrode Limb |
| 95909-CPT | Low | Motor &/Sens 5-6 Nrv Cndj Preconf Eltrode Limb |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95875. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95875 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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