CPT 95886 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 • RT - Right side of body |
| Complexity Level | Low |
National average reimbursement for CPT 95886 by major payers:
$113.75
$121.97
$129.58
$163.24
| 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 95886 | ||||||
United | 95886 | $88.86 | 1952560492 - TAKIJAH HEARD | 363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95886 | $65.45 | 1932272952 - MOHAMMED HOMSI | 363978153 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95886 | $60.15 | 1407848286 - ELIZABETH MIRKIN | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 95886 | $112.50 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | AZ | Psychiatry Physician (2084P0800X) |
United | 95886 | $58.93 | 1235766916 - AMIRREZA FALLAHI | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 95886 | $71.95 | 1871793869 - ANOOSH SALMAN | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95886 | $191.39 | 1114196995 - ANGELA GREEN | 910844563 | LA | Psychiatry Physician (2084P0800X) |
United | 95886 | $248.63 | 1659714806 - RAVI RAMASAMY | 911336707 - THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95886 | $175.67 | 1144203753 - HAIDAR KABBANI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95886 | $134.99 | 1659714806 - RAVI RAMASAMY | 910564748 - SEATTLE CHILDRENS HOSPITAL | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95886 | $63.61 | 1780651588 - PATRICIA MUMBY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 95886 | $114.29 | 1568921476 - YU ZHANG | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 95886 | $205.49 | 1225211600 - JOHN MILLICHAP | 911352172 - MULTICARE HEALTH SYSTEM | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95886 | $46.81 | 1396945671 - REGINA HALL-NGORIMA | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 95886 | $103.16 | 1558867523 - SULAIMAN FAROOQUI | 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 95886 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95886 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 95886 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 |
|---|---|---|
| 95870-CPT | Low | Needle Electromyography; Limited Study Of Muscles In 1 Extremity Or Non-Limb (Axial) Muscles (Unilateral Or Bilateral), Other Than Thoracic Paraspinal, Cranial Nerve Supplied Muscles, Or Sphincters |
| 95885-CPT | Low | Needle Electromyography Each Extremity With Related Paraspinal Areas When Performed Done With Nerve Conduction Amplitude And Latency/ Velocity Study; Limited (List Separately In Addition To Code For Primary Procedure) |
| 95886-CPT | Low | Needle Electromyography Each Extremity With Related Paraspinal Areas When Performed Done With Nerve Conduction Amplitude And Latency/ Velocity Study; Complete Five Or More Muscles Studied Innervated By Three Or More Nerves Or Four Or More Spinal Levels (List Separately In Addition To Code For Primary Procedure) |
| 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95886. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95886 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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