| Code | Description | States | Median rate |
|---|---|---|---|
| 95004 | Allergy skin tests, percutaneous, per test | 48 | $3.13 |
| 95012 | Exhaled nitric oxide test | 41 | $16.01 |
| 95017 | Allergy skin testing for insect venom, per test | 46 | $6.69 |
| 95018 | Allergy skin testing for drugs, per test | 47 | $16.03 |
| 95024 | Intradermal allergy tests, each | 48 | $5.97 |
| 95027 | Intradermal allergy test, airborne allergens, per test | 43 | $4.01 |
| 95028 | Intradermal allergy test, delayed reading, per test | 47 | $9.53 |
| 95044 | Allergy patch test, per test | 48 | $4.65 |
| 95052 | Photo patch allergy test, per test | 45 | $5.38 |
| 95056 | Photo (light sensitivity) tests | 44 | $36.78 |
| 95060 | Eye allergy test | 47 | $30.74 |
| 95065 | Nasal allergy challenge test | 45 | $21.72 |
| 95070 | Inhaled airway challenge with histamine or methacholine | 47 | $34.43 |
| 95076 | Food or drug challenge test, first 2 hours | 46 | $96.66 |
| 95079 | Food or drug challenge test, each added hour | 45 | $68.68 |
| 95115 | Allergy shot, single injection | 48 | $8.71 |
| 95117 | Allergy shots, 2 or more injections | 48 | $10.65 |
| 95120 | Allergy shot with extract, single injection | 24 | $9.00 |
| 95125 | Allergy shots with extract, 2 or more injections | 23 | $14.42 |
| 95130 | Insect venom allergy shot with extract, 1 venom | 26 | $16.89 |
| 95131 | Insect venom allergy shot with extract, 2 venoms | 26 | $20.73 |
| 95132 | Insect venom allergy shot with extract, 3 venoms | 26 | $24.97 |
| 95133 | Insect venom allergy shot with extract, 4 venoms | 25 | $26.97 |
| 95134 | Insect venom allergy shot with extract, 5 venoms | 23 | $32.06 |
| 95144 | Allergy shot extract preparation, single-dose vials | 46 | $13.19 |
| 95145 | Allergy shot extract preparation, one insect venom | 46 | $26.31 |
| 95146 | Allergy shot extract preparation, two insect venoms | 46 | $47.39 |
| 95147 | Allergy shot extract preparation, three insect venoms | 46 | $45.62 |
| 95148 | Allergy shot extract preparation, four insect venoms | 45 | $60.56 |
| 95149 | Allergy shot extract preparation, five insect venoms | 45 | $86.45 |
| 95165 | Preparation of allergy shot vials, multi-dose | 46 | $11.85 |
| 95170 | Allergy shot extract preparation, biting insect | 44 | $8.64 |
| 95180 | Rapid drug desensitization, each hour | 47 | $112.30 |
| 95199 | Unlisted allergy or immunology service | 10 | $19.93 |
| 95249 | Continuous glucose monitor setup, patient-owned device | 40 | $48.97 |
| 95250 | Continuous glucose monitor setup, office-owned device | 44 | $121.66 |
| 95251 | Continuous glucose monitor data interpretation | 44 | $28.96 |
| 95700 | Long-term EEG set-up with video, by technologist | 37 | $201.07 |
| 95705 | Long-term EEG, no video, 2-12 hours, unmonitored | 37 | $147.76 |
| 95706 | Long-term EEG, no video, 2-12 hours, intermittent monitor | 36 | $250.57 |
| 95707 | Long-term EEG, no video, 2-12 hours, continuous monitor | 35 | $286.27 |
| 95709 | Long-term EEG, no video, 12-26 hours, intermittent monitor | 35 | $485.61 |
| 95710 | Long-term EEG, no video, 12-26 hours, continuous monitor | 35 | $537.66 |
| 95711 | Long-term video EEG, 2-12 hours, unmonitored | 36 | $172.12 |
| 95712 | Long-term video EEG, 2-12 hours, intermittent monitor | 36 | $293.65 |
| 95713 | Long-term video EEG, 2-12 hours, continuous monitor | 35 | $441.80 |
| 95714 | Long-term video EEG, 12-26 hours, unmonitored | 37 | $241.34 |
| 95715 | Long-term video EEG, 12-26 hours, intermittent monitor | 36 | $537.87 |
| 95716 | Long-term video EEG, 12-26 hours, continuous monitor | 35 | $883.63 |
| 95782 | Sleep study, under age 6, attended | 48 | $814.29 |
| 95783 | Sleep study, under age 6, with CPAP or bilevel start | 48 | $860.51 |
| 95800 | Home sleep study with sleep time | 45 | $124.63 |
| 95801 | Home sleep test, heart rate, oxygen and breathing | 32 | $84.22 |
| 95803 | Actigraphy sleep-wake recording, 3 to 14 days | 24 | $108.88 |
| 95805 | Daytime sleepiness test (multiple sleep latency) | 48 | $375.91 |
| 95806 | Home sleep study, airflow and effort | 40 | $89.06 |
| 95810 | Sleep study in a facility, attended | 48 | $542.42 |
| 95811 | Sleep study with CPAP titration, attended | 48 | $585.67 |
| 95812 | EEG, extended, 41 to 60 minutes | 48 | $260.88 |
| 95813 | EEG, extended, 61 to 119 minutes | 48 | $337.37 |
| 95816 | EEG (brain wave test), awake and drowsy | 47 | $288.12 |
| 95819 | EEG (brain wave test), awake and asleep | 48 | $337.61 |
| 95822 | EEG in coma or sleep only | 46 | $306.00 |
| 95824 | EEG for brain death evaluation | 43 | $51.28 |
| 95829 | Brain surface EEG during surgery | 46 | $1,345.58 |
| 95830 | Sphenoidal electrode placement for EEG | 42 | $461.89 |
| 95836 | Brain recording from an implanted stimulator, up to 30 days | 40 | $88.09 |
| 95851 | Range-of-motion measurement, each limb or spine section | 47 | $17.24 |
| 95857 | Myasthenia gravis drug challenge test | 45 | $47.61 |
| 95860 | Needle EMG, one limb | 48 | $87.28 |
| 95861 | Needle EMG, two limbs | 48 | $124.39 |
| 95863 | Needle EMG, three limbs | 48 | $161.53 |
| 95864 | Needle EMG, four limbs | 48 | $180.69 |
| 95865 | Needle EMG, voice box | 47 | $115.37 |
| 95866 | Needle EMG, diaphragm | 47 | $99.76 |
| 95867 | Needle EMG, face or head muscles, one side | 48 | $82.26 |
| 95868 | Needle EMG, face or head muscles, both sides | 48 | $100.87 |
| 95869 | Needle EMG, mid-back spine muscles | 48 | $63.48 |
| 95870 | Needle EMG, limited study | 48 | $63.40 |
| 95872 | Single-fiber EMG | 47 | $149.65 |
| 95873 | Electrical stimulation guidance for botulinum (add-on) | 44 | $55.76 |
| 95874 | Needle EMG guidance for botulinum injection (add-on) | 45 | $59.43 |
| 95885 | Needle EMG with nerve conduction, limited, per limb | 48 | $49.99 |
| 95886 | Needle EMG, each limb, complete study (add-on) | 48 | $77.26 |
| 95887 | Needle EMG with nerve conduction, head or trunk muscles | 48 | $68.61 |
| 95905 | Nerve conduction study with preset electrode array, per limb | 45 | $36.34 |
| 95907 | Nerve conduction studies, 1-2 nerves | 48 | $75.60 |
| 95908 | Nerve conduction studies, 3-4 nerves | 48 | $92.80 |
| 95909 | Nerve conduction studies, 5-6 nerves | 48 | $110.63 |
| 95910 | Nerve conduction studies, 7-8 nerves | 48 | $146.88 |
| 95911 | Nerve conduction studies, 9 to 10 nerves | 48 | $176.58 |
| 95912 | Nerve conduction studies, 11 to 12 nerves | 48 | $206.96 |
| 95913 | Nerve conduction studies, 13 or more nerves | 48 | $240.81 |
| 95921 | Autonomic nerve testing, parasympathetic (heart rate) | 43 | $67.50 |
| 95922 | Autonomic nerve testing, sympathetic (blood pressure) | 43 | $70.92 |
| 95923 | Autonomic nerve testing, sweat function | 41 | $98.75 |
| 95924 | Autonomic nerve testing with tilt | 43 | $125.22 |
| 95925 | Sensory nerve pathway test (evoked potentials), arms | 48 | $118.61 |
| 95926 | Sensory nerve pathway test (evoked potentials), legs | 48 | $108.01 |
| 95927 | Sensory nerve pathway test (evoked), trunk or head | 48 | $131.71 |
| 95928 | Motor nerve pathway test (evoked potentials), arms | 48 | $192.07 |
| 95929 | Motor nerve pathway test (evoked potentials), legs | 48 | $191.04 |
| 95930 | Visual pathway test (evoked potentials) | 47 | $61.59 |
| 95933 | Blink reflex nerve test | 43 | $65.29 |
| 95937 | Nerve-muscle junction test (repetitive stimulation) | 47 | $80.59 |
| 95938 | Sensory nerve pathway test (evoked), arms and legs | 48 | $278.51 |
| 95939 | Motor nerve pathway test (evoked), arms and legs | 48 | $424.40 |
| 95940 | Nerve monitoring during surgery, in the room, each 15 min | 43 | $24.26 |
| 95954 | EEG with drug or physical activation, physician attended | 45 | $295.63 |
| 95955 | EEG monitoring during surgery (not brain surgery) | 43 | $152.82 |
| 95957 | Digital EEG analysis (spike analysis) | 45 | $212.10 |
| 95958 | Wada test (brain hemisphere function) | 46 | $520.98 |
| 95961 | Brain mapping by electrode stimulation, first hour | 45 | $258.75 |
| 95962 | Brain mapping by electrode stimulation, each added hour | 44 | $233.16 |
| 95965 | Magnetoencephalography (MEG), spontaneous activity | 37 | $820.97 |
| 95966 | Magnetoencephalography (MEG), evoked fields, one modality | 37 | $480.20 |
| 95967 | Magnetoencephalography (MEG), each added modality | 37 | $317.74 |
| 95972 | Nerve stimulator programming, complex | 46 | $54.46 |
| 95980 | Stomach stimulator programming during surgery | 37 | $33.00 |
| 95981 | Stomach stimulator check, no reprogramming | 38 | $29.28 |
| 95982 | Stomach stimulator check with reprogramming | 38 | $44.61 |
| 95983 | Brain stimulator programming, first 15 minutes | 46 | $43.04 |
| 95984 | Brain stimulator programming, each added 15 minutes | 45 | $37.21 |
| 95990 | Spinal or brain drug pump refill | 46 | $66.37 |
| 95991 | Spinal or brain drug pump refill by a physician | 46 | $87.87 |
| 95992 | Epley maneuver for vertigo, per day | 38 | $36.24 |
| 95999 | Unlisted neurological procedure | 11 | $97.72 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.