CPT 95999 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital • 15 - Mobile Unit |
| Common Modifiers | • None • 59 - Distinct Procedural Service • GY - Notice of Liability Not Issued, Not Required Under Payer Policy. |
| Complexity Level | Moderate |
National average reimbursement for CPT 95999 by major payers:
$915.72
$41.09
$2,786.91
$228.49
| 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 95999 | ||||||
United | 95999 | $201.60 | 1396837951 - CENTRAL IOWA HOSPITAL CORPORATION, IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 95999 | $286.00 | 1619676251 - TATE COUNTY HOSPITAL | 922135241 - (MS) TATE COUNTY HOSPITAL | MS | General Acute Care Hospital (282N00000X) |
United | 95999 | $163.17 | 1003996000 - THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON, NORTHEAST ALABAMA REGIONAL MEDICAL CENTER | 636000090 - THE HEALTH CARE AUTHORITY OF THE CITY OF ANNISTON | AL | General Acute Care Hospital (282N00000X) |
United | 95999 | $271.95 | 1740876382 - DELTA HEALTH SYSTEM, DELTA HEALTH-NORTHWEST REGIONAL | 853959101 | MS | General Acute Care Hospital (282N00000X) |
United | 95999 | $554.45 | 1548322720 - NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION, HAZLETON GENERAL HOSPITAL | 232421970 - (PA) NORTHEASTERN PENNSYLVANIA HEALTH CORPORATION | PA | General Acute Care Hospital (282N00000X) |
United | 95999 | $1076.78 | 1073510277 - PEACEHEALTH, ST. JOHN MEDICAL CENTER | 910564987 | WA | General Acute Care Hospital (282N00000X) |
United | 95999 | $478.82 | 1851686059 - SWEDISH HEALTH SERVICES, SWEDISH/ISSAQUAH | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | General Acute Care Hospital (282N00000X) |
United | 95999 | $589.03 | 1093713091 - ST FRANCIS COMMUNITY HOSPITAL, FRANCISCAN HEALTH SYSTEM | 911267921 - (WA) ST FRANCIS COMMUNITY HOSPITAL | WA | General Acute Care Hospital (282N00000X) |
United | 95999 | $350.92 | 1598905762 - CENTRAL IOWA HOSPITAL CORPORATION, UNITYPOINT HEALTH - DES MOINES IOWA METHODIST MEDICAL CENTER | 420680452 - CENTRAL IOWA HOSPITAL CORPORATION | IA | General Acute Care Hospital (282N00000X) |
United | 95999 | $356.17 | 1730115940 - HILLSDALE COMMUNITY HEALTH CENTER, HILLSDALE HOSPITAL | 386005550 - HILLSDALE COMMUNITY HEALTH CENTER | MI | General Acute Care Hospital (282N00000X) |
United | 95999 | $663.23 | 1891233045 - PRESBYTERIAN HEALTHCARE SERVICES | 850105601 - PRESBYTERIAN HEALTHCARE SERVICES | NM | General Acute Care Hospital (282N00000X) |
United | 95999 | $303.54 | 1477640258 - ST. JOSEPH'S HOSPITAL, YONKERS | 131740127 - (NY) ST JOSEPHS HOSPITAL YONKERS | NY | General Acute Care Hospital (282N00000X) |
United | 95999 | $378.98 | 1982625661 - NICHOLAS H. NOYES MEMORIAL HOSPITAL | 160743979 - (NY) NICHOLAS H NOYES MEMORIAL HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 95999 | $605.34 | 1396402053 - LEHIGH VALLEY HOSPITAL- POCONO, POCONO MEDICAL CENTER | 240795623 - (PA) POCONO MEDICAL CENTER | PA | General Acute Care Hospital (282N00000X) |
United | 95999 | $448.29 | 1861432726 - OVERLAKE HOSPITAL MEDICAL CENTER | 910652651 - (WA) OVERLAKE HOSPITAL MEDICAL CENTER | WA | General Acute Care Hospital (282N00000X) |
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 95999 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95999 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 95999 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 |
|---|---|---|
| 95983-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg, Contact Group[S], Interleaving, Amplitude, Pulse Width, Frequency [Hz], On/Off Cycling, Burst, Magnet Mode, Dose Lockout, Patient Selectable Parameters, Responsive Neurostimulation, Detection Algorithms, Closed Loop Parameters, And Passive Parameters) By Physician Or Other Qualified Health Care Professional; With Brain Neurostimulator Pulse Generator/Transmitter Programming, First 15 Minutes Face-To-Face Time With |
| 95984-CPT | Low | Electronic Analysis Of Implanted Neurostimulator Pulse Generator/Transmitter (Eg, Contact Group[S], Interleaving, Amplitude, Pulse Width, Frequency [Hz], On/Off Cycling, Burst, Magnet Mode, Dose Lockout, Patient Selectable Parameters, Responsive Neurostimulation, Detection Algorithms, Closed Loop Parameters, And Passive Parameters) By Physician Or Other Qualified Health Care Professional; With Brain Neurostimulator Pulse Generator/Transmitter Programming, Each Additional 15 Minutes Face-To-Face |
| 95990-CPT | Low | Refilling And Maintenance Of Implantable Pump Or Reservoir For Drug Delivery, Spinal (Intrathecal, Epidural) Or Brain (Intraventricular), Includes Electronic Analysis Of Pump, When Performed; |
| 95999-CPT | Moderate | Unlisted Neurological Or Neuromuscular Diagnostic Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95999 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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