CPT 95925 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 • 21 - Inpatient Hospital • 15 - Mobile Unit |
| Common Modifiers | • None • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | Moderate |
National average reimbursement for CPT 95925 by major payers:
$200.45
$173.15
$208.47
$254.02
| 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 95925 | ||||||
United | 95925 | $60.41 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | MS | Psychiatry Physician (2084P0800X) |
United | 95925 | $339.36 | 1205213261 - TAMAR CACERES | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurodevelopmental Disabilities Physician (2084P0005X) |
United | 95925 | $53.86 | 1518318716 - LADAN KHAZAI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 95925 | $193.19 | 1639691090 - KELLY RHODES | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 95925 | $64.86 | 1740505569 - MEGHAN O'NEILL | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95925 | $269.29 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 95925 | $198.30 | 1386755486 - DOUGLAS NORDLI | 362177139 - UNIVERSITY OF CHICAGO | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95925 | $231.82 | 1639691090 - KELLY RHODES | 363167726 - (IL) RIVERSIDE HEALTH SYSTEM | IL | Psychiatry Physician (2084P0800X) |
United | 95925 | $53.86 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | FL | Psychiatry Physician (2084P0800X) |
United | 95925 | $196.66 | 1538112859 - FARHA TOKARZ | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95925 | $38.40 | 1679526784 - ELTON SMITH | 911031583 | NC | Psychiatry Physician (2084P0800X) |
United | 95925 | $55.68 | 1730263617 - MARK ALTER | 910844563 | NJ | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95925 | $406.47 | 1740252972 - DAVID HSU | 391678306 - AURORA MEDICAL GROUP INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95925 | $43.97 | 1083759344 - SACHIN BHALERAO | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95925 | $214.49 | 1245252303 - MARY FAHRMEIER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | 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 95925 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95925 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 95925 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 |
|---|---|---|
| 95925-CPT | Moderate | Short-Latency Somatosensory Evoked Potential Study, Stimulation Of Any/All Peripheral Nerves Or Skin Sites, Recording From The Central Nervous System; In Upper Limbs |
| 95926-CPT | Low | Short-Latency Somatosensory Evoked Potential Study, Stimulation Of Any/All Peripheral Nerves Or Skin Sites, Recording From The Central Nervous System; In Lower Limbs |
| 95927-CPT | Low | Short-Latency Somatosensory Evoked Potential Study, Stimulation Of Any/All Peripheral Nerves Or Skin Sites, Recording From The Central Nervous System; In The Trunk Or Head |
| 95937-CPT | Low | Neuromuscular Junction Test,Ea.Nerve,Any |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95925. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95925 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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