CPT 95921 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 • None |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
National average reimbursement for CPT 95921 by major payers:
$102.95
$104.53
$103.51
$135.84
| 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 95921 | ||||||
United | 95921 | $41.61 | 1154586972 - MARILYN LLAVONA-SUAREZ | 461021329 - (FL) HEALTH HOLDINGS COMPANY, LLC | FL | General Practice Physician (208D00000X) |
United | 95921 | $71.31 | 1740275429 - CARLOS ZAYAS TORRES | 593259553 - ORLANDO HEALTH MEDICAL GROUP INC | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 95921 | $140.58 | 1093164949 - ROBERTO BORRERO LUGO | 590634434 - SACRED HEART HEALTH SYSTEM INC | FL | Internal Medicine Physician (207R00000X) |
United | 95921 | $44.84 | 1366540502 - SHIRISKUMAR PATEL | 593411454 - (FL) WEST FLORIDA MEDICAL ASSOCIATES P.A. | FL | Family Medicine Physician (207Q00000X) |
United | 95921 | $63.63 | 1184088098 - JARELYS HERNANDEZ JIMENEZ | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Internal Medicine Physician (207R00000X) |
United | 95921 | $65.77 | 1497719710 - RON ARISON MD PL LLC | 30515654 - (FL) RON ARISON MD PL LLC | FL | Surgery Physician (208600000X) |
United | 95921 | $71.31 | 1720540560 - SHIVANGI PATEL | 593259553 - ORLANDO HEALTH MEDICAL GROUP INC | FL | Internal Medicine Physician (207R00000X) |
United | 95921 | $22.14 | 1942398714 - LYDIA PUENTE | 20555474 - (FL) LYDIA PUENTE PA | FL | Family Medicine Physician (207Q00000X) |
United | 95921 | $37.08 | 1215901285 - MIRTA GALANTE | 591199726 - (FL) FLAGLER MEDICAL ASSOCIATES, P.A. | FL | Internal Medicine Physician (207R00000X) |
United | 95921 | $29.68 | 1760477269 - PRASAD CHALASANI | 650867498 - (FL) FLORIDA HEART CENTER, P.A. | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 95921 | $113.94 | 1285606442 - ANDREW GUZMAN | 800412061 | FL | Family Medicine Physician (207Q00000X) |
United | 95921 | $72.12 | 1194774604 - JACOB AGAMASU | 593149293 - SOUTHWEST VOLUSIA HEALTHCARE CORPORATION | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 95921 | $29.42 | 1871992545 - SUN CITY CENTER HEALTH AND WELLNESS LLC | 471598263 - (FL) SUN CITY CENTER HEALTH AND | FL | General Practice Physician (208D00000X) |
United | 95921 | $131.38 | 1538173026 - STEVEN ATTERMANN | 593214635 - FLORIDA HOSPITAL MEDICAL GROUP INC | FL | Internal Medicine Physician (207R00000X) |
United | 95921 | $33.63 | 1730284456 - SRIKANTH MALEMPATI | 463685614 - (FL) BOWMAN & HAMPSEY MEDICAL CLINIC, INC. | FL | Internal Medicine Physician (207R00000X) |
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 95921 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95921 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 95921 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 95921. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95921 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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