CPT 95919 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 • 20 - Urgent Care Facility |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 95919 by major payers:
$19.44
$20.02
$19.25
$35.03
| 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 95919 | ||||||
United | 95919 | $17.77 | 1013538636 - OYOYO SAWYER | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 95919 | $34.74 | 1710244991 - ALBA PERGJIKA | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95919 | $8.75 | 1679739395 - BETSY OSTRANDER | 942854057 - IHC HEALTH SERVICES INC | UT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95919 | $28.45 | 1356397210 - M SHEIKH | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95919 | $6.05 | 1487755955 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 95919 | $21.20 | 1720547672 - PERRY TSAI | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 95919 | $14.84 | 1972910404 - DAVID BIEBER | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95919 | $20.00 | 1447264932 - CYNTHIA STACK | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95919 | $5.69 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95919 | $17.87 | 1306259817 - KHALID ARSHAD | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95919 | $17.92 | 1336431667 - SURAYA KAWADRY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 95919 | $20.19 | 1245252303 - MARY FAHRMEIER | 910844563 | VA | Psychiatry Physician (2084P0800X) |
United | 95919 | $39.16 | 1891921367 - KAVITA THAKKAR | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95919 | $17.92 | 1376063370 - ABBY FREDRICKSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MN | Psychiatry Physician (2084P0800X) |
United | 95919 | $9.42 | 1588761142 - MONA LAL | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | 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 95919 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95919 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 95919 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 |
|---|---|---|
| 95919-CPT | Low | Quantitative Pupillometry With Physician Or Other Qualified Health Care Professional Interpretation And Report, Unilateral Or Bilateral |
| 95921-CPT | Low | Testing Of Autonomic Nervous System Function; Cardiovagal Innervation (Parasympathetic Function), Including 2 Or More Of The Following: Heart Rate Response To Deep Breathing With Recorded R-R Interval, Valsalva Ratio, And 30:15 Ratio |
| 95922-CPT | Low | Testing Of Autonomic Nervous System Function; Vasomotor Adrenergic Innervation (Sympathetic Adrenergic Function) Including Beat-To-Beat Blood Pressure And R-R Interval Changes During Valsalva Maneuver And At Least Five Minutes Of Passive Tilt |
| 95923-CPT | Low | Testing Of Autonomic Nervous System Function; Sudomotor, Including 1 Or More Of The Following: Quantitative Sudomotor Axon Reflex Test (Qsart), Silastic Sweat Imprint, Thermoregulatory Sweat Test, And Changes In Sympathetic Skin Potential |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95919. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95919 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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