CPT 95966 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 • TC - Technical component |
| Complexity Level | High |
National average reimbursement for CPT 95966 by major payers:
$1,037.22
$1,627.93
$1,227.82
$1,715.49
| 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 95966 | ||||||
United | 95966 | $2610.67 | 1518037126 - MARY LAKE | 364187449 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95966 | $1120.00 | 1609296714 - JOHN ZULUETA | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $1395.54 | 1962589390 - KATHLEEN KELLEY | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95966 | $2362.40 | 1740252972 - DAVID HSU | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95966 | $1657.03 | 1336431667 - SURAYA KAWADRY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | FL | Psychiatry Physician (2084P0800X) |
United | 95966 | $1545.85 | 1760907133 - ILLINOIS PROFESSIONALS HEALTH PROGRAM, LLC | 815174138 - (IL) ILLINOIS PROFESSIONALS HEALTH PROGR | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $1788.71 | 1679968697 - JEREMIAH BREWER | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $229.74 | 1033640198 - ABDULLAH BIN MAHFODH | 815143225 - (IL) COMMUNITY HOME PHYSICIANS LLC D/B/A COMMUNITY PHYSICIANS | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $343.92 | 1326465436 - MUSADDIQ TARIQ | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MS | Psychiatry Physician (2084P0800X) |
United | 95966 | $359.70 | 1083979124 - RAHUL SHARMA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $2964.12 | 1730263617 - MARK ALTER | 910844563 | PA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95966 | $629.47 | 1194049676 - TRACY BINIUS | 205996177 | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $1198.18 | 1194430504 - JULIA LOZA-VEGA | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physician Assistant (363A00000X) |
United | 95966 | $1657.03 | 1679968697 - JEREMIAH BREWER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 95966 | $423.86 | 1881918415 - TUSHAR ADVANI | 910844563 | 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 95966 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95966 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 95966 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 |
|---|---|---|
| 95957-CPT | Moderate | Digital Analysis Of Electroencephalogram(Eeg)(Eg F/Epilptc Spik Anlys) |
| 95958-CPT | Moderate | Wada Activ Test Incl Eeg Monit |
| 95962-CPT | Moderate | Functional Cortical And Subcortical Mapping By Stimulation And/Or Recording Of Electrodes On Brain Surface Or Of Depth Electrodes To Provoke Seizures Or Identify Vital Brain Structures; Each Additional Hour Of Attendance By A Physician Or Other Qualified Health Care Professional (List Separately In Addition To Code For Primary Procedure) (Revised 01/01/13) |
| 95966-CPT | High | Magnetoencephalography (Meg), Recording And Analysis; For Evoked Magnetic Fields, Single Modality (Eg, Sensory, Motor, Language, Or Visual Cortex Localization) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95966. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95966 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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