CPT 95992 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 • GP - Services delivered under an outpatient physical therapy plan of care • 59 - Distinct Procedural Service |
| Complexity Level | Low |
National average reimbursement for CPT 95992 by major payers:
$56.07
$56.21
$57.33
$69.97
| 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 95992 | ||||||
United | 95992 | $110.20 | 1063471159 - MARK WAINWRIGHT | 911336707 - THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $86.63 | 1780976399 - ANNA JEONG | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $83.66 | 1669598421 - CHANDRIKA SHANKAR | 911780160 | NY | Psychiatry Physician (2084P0800X) |
United | 95992 | $94.80 | 1285715847 - SHANNON JENNINGS | 362604009 - (IL) OTTAWA REGIONAL HOSPITAL & HEALTHCARE CENTER | MO | Psychiatry Physician (2084P0800X) |
United | 95992 | $87.36 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 95992 | $42.95 | 1720532773 - ADULT AND PEDIATRIC NEUROLOGY | 813062689 - (IL) ADULT AND PEDIATRIC NEUROLOGY | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $85.86 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 95992 | $75.76 | 1609039163 - HUMA ABBAS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95992 | $64.44 | 1932272952 - MOHAMMED HOMSI | 363978153 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $55.00 | 1588756076 - ALL WAYS HOMECARE INC | 202696236 | FL | Home Health Agency (251E00000X) |
United | 95992 | $65.05 | 1023438009 - MOLLY MCINTOSH | 593140335 - BAYCARE MEDICAL GROUP INC | FL | Home Health Agency (251E00000X) |
United | 95992 | $105.43 | 1578957676 - LAURA VERNON | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NY | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $85.86 | 1063972404 - MAANASA BANDLA | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95992 | $85.69 | 1225211600 - JOHN MILLICHAP | 731310891 - WARREN CLINIC INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95992 | $85.86 | 1326465436 - MUSADDIQ TARIQ | 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 95992 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95992 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 95992 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 |
|---|---|---|
| 95992-CPT | Low | Canalith Repositioning Procedure(S) (Eg, Epley Maneuver, Semont Maneuver), Per Day |
| 95999-CPT | Moderate | Unlisted Neurological Or Neuromuscular Diagnostic Procedure |
| 96000-CPT | Low | Comprehensive Computer-Based Motion Analysis By Video-Taping And 3-D Kinematics |
| 96001-CPT | Low | Comprehensive Computer-Based Motion Analysis By Video-Taping And 3-D Kinematics; With Dynamic Plantar Pressure Measurements During Walking |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95992. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95992 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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