CPT code 95076: Ingestion challenge, initial 120 minutes2026 Medicare rate & RVUs in Idaho

Reports supervised oral challenge testing, such as a food or medication challenge, for the initial testing interval used to assess a suspected reaction.

CMS RVU26DEffective Oct 1, 2026One payment locality12.9K Medicare services in 2024

In Idaho, Medicare pays $116.50 for 95076 in the office and $60.58 when it’s performed in a hospital or facility.

$116.50Office (non-facility)
$60.58Hospital or facility
−5.5%vs the national office rate ($123.25)

Check a contract rate as a % of Medicare · 95076 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 95076 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Idaho
  2. What 95076 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 95076 covers

An ingestion challenge involves giving a patient measured, sequential amounts of a suspected food or medication by mouth while observing for an allergic response. Allergists and other clinicians experienced in allergy evaluation commonly perform these challenges in an office or facility equipped to monitor the patient and respond to reactions. Examples include assessing whether a patient can tolerate a food or an oral medication after a history of possible allergy.

Report 95076 for the initial testing interval; when testing continues beyond that interval, 95079 is the add-on code for additional testing time. Documentation should identify the ingested substance, the incremental doses or challenge steps, the testing time, observations, and any symptoms or intervention. CMS physician fee schedule values for this service include physician work, practice expense, and malpractice components, with practice expense values differing between office and facility settings.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Idaho compares for 95076

Across 109 of 109 payment localities, the office rate for 95076 runs from $112.25 in Arkansas to $159.28 in San Benito County, CA. Idaho pays $116.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

95076 in Idaho vs other payment areas
  1. Idaho · this page$116.50
  2. Los Angeles, CA · California$137.65+$21.15
  3. Washington, DC area · District of Columbia$138.84+$22.34
  4. Miami, FL · Florida$129.23+$12.73
  5. Chicago, IL · Illinois$126.55+$10.05
  6. Manhattan, NY · New York$139.16+$22.66
  7. Alaska · Alaska$152.02+$35.52

Other areas in Idaho first, then benchmark localities. Bars start at $0.

Every other payment area

95076 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$113.49$60.30
ArkansasArkansas$112.25$60.03
ArizonaArizona$120.76$61.85
Bakersfield, CACalifornia$130.25$63.62
Chico, CACalifornia$130.00$63.38
El Centro, CACalifornia$130.01$63.39
Fresno, CACalifornia$130.00$63.38
Hanford, CACalifornia$130.00$63.38

95076 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$112.25

$152.02

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95076 office rate range by state
State / territoryOffice rate rangeLocalities
AK$152.021
AL$113.491
AR$112.251
AZ$120.761
CA$130.00–$159.2829
CO$127.961
CT$130.151
DC$138.841
DE$122.441
FL$121.13–$129.233
GA$115.95–$124.942
GU$132.151
HI$132.151
IA$115.991
ID$116.501
IL$118.19–$127.074
IN$117.031
KS$115.431
KY$115.181
LA$114.98–$119.322
MA$127.41–$138.882
MD$124.44–$138.843
ME$116.80–$121.872
MI$117.32–$122.132
MN$123.901
MO$113.38–$119.843
MS$112.841
MT$123.251
NC$117.761
ND$122.061
NE$116.521
NH$125.921
NJ$131.99–$137.932
NM$117.751
NV$122.991
NY$119.10–$141.625
OH$117.081
OK$115.191
OR$122.37–$131.432
PA$117.31–$127.452
PR$124.001
RI$126.331
SC$117.541
SD$121.921
TN$115.851
TX$116.70–$127.258
UT$118.781
VA$121.45–$138.842
VI$124.001
VT$121.551
WA$127.19–$141.542
WI$118.871
WV$114.791
WY$122.731

See 95076 in every payment locality

How the 95076 rate is calculated

Each of 95076’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 95076

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.50

1.50 RVUs× 1.000 GPCI

Practice expense2.13

2.13 RVUs× 1.000 GPCI

Malpractice0.06

0.06 RVUs× 1.000 GPCI

Adjusted RVUs

3.6900

Conversion factor

$33.4009

Medicare rate

$123.25

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Idaho inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,470

Code
95076
Physician work
1.50
Practice expense
2.13
Malpractice
0.06

GPCI2026.csv

47

Locality
Idaho
Physician work
1.000
Practice expense
0.920
Malpractice
0.473
Office calculation for 95076 in Idaho
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0001.5000
Practice expense2.13× 0.9201.9596
Malpractice0.06× 0.4730.0284
Total RVUs3.4880
Conversion factor× 33.4009

Office rate, Idaho$116.50

Office: (1.5 × 1 + 2.13 × 0.92 + 0.06 × 0.473) × $33.4009 = $116.50

Facility: (1.5 × 1 + 0.31 × 0.92 + 0.06 × 0.473) × $33.4009 = $60.58

Open 95076 in the RVU calculator

Payment rules and modifiers for 95076

95076 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

Place of service · 95076

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

$123.25

Non-facility (office)
$123.25
Facility
$62.46

Higher because the practice carries its own overhead.

How 95076 has changed in Idaho

95076 · Office / nonfacility

$116.50

Effective 2026-10-01

The base rate is $2.91 higher than on 2025-10-01, moving from $113.59 to $116.50 (2.6%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $113.59changed to$116.50

    • Conversion factor 32.3465 changed to 33.4009
    • Practice expense RVU 2.19 changed to 2.13
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.908 changed to 0.920
    • Malpractice GPCI 0.461 changed to 0.473

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $115.53changed to$113.59

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.14 changed to 2.19
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $113.65changed to$115.53

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $113.46changed to$113.65

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.14
    • Practice expense GPCI 0.893 changed to 0.908
    • Malpractice GPCI 0.439 changed to 0.461
  5. January 1, 2023

    RVU23A

    $111.80changed to$113.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.94 changed to 2.04
    • Malpractice RVU 0.07 changed to 0.06
    • Practice expense GPCI 0.877 changed to 0.893
    • Malpractice GPCI 0.416 changed to 0.439

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $110.90changed to$111.80

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.89 changed to 1.94
    • Malpractice RVU 0.05 changed to 0.07

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $113.28changed to$110.90

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.81 changed to 1.89
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.890 changed to 0.877
    • Malpractice GPCI 0.464 changed to 0.416

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $115.95changed to$113.28

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.87 changed to 1.81
    • Practice expense GPCI 0.902 changed to 0.890
    • Malpractice GPCI 0.512 changed to 0.464

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $114.53changed to$115.95

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.83 changed to 1.87

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $110.49changed to$114.53

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.72 changed to 1.83
    • Practice expense GPCI 0.900 changed to 0.902
    • Malpractice GPCI 0.510 changed to 0.512

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $110.42changed to$110.49

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.73 changed to 1.72
    • Practice expense GPCI 0.898 changed to 0.900
    • Malpractice GPCI 0.508 changed to 0.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $110.31changed to$110.42

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 1.72 changed to 1.73
    • Malpractice RVU 0.05 changed to 0.06

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $109.77changed to$110.31

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $110.26changed to$109.77

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.73 changed to 1.72
    • Practice expense GPCI 0.896 changed to 0.898
    • Malpractice GPCI 0.556 changed to 0.508

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $109.55changed to$110.26

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.89 changed to 1.73
    • Practice expense GPCI 0.894 changed to 0.896
    • Malpractice GPCI 0.603 changed to 0.556

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $109.55

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$116.50$60.58RVU26D
2026-07-01$116.50$60.58RVU26C
2026-04-01$116.50$60.58RVU26B
2026-01-01$116.50$60.58RVU26A
2025-10-01$113.59$68.06RVU25D
2025-07-01$113.59$68.06RVU25C
2025-04-01$113.59$68.06RVU25B
2025-01-01$113.59$68.06RVU25A
2024-10-01$115.53$69.59RVU24D
2024-07-01$115.53$69.59RVU24C
2024-04-01$115.53$69.59RVU24B
2024-03-09$115.53$69.59RVU24AR
2024-01-01$113.65$68.46RVU24A
2023-10-01$113.46$70.18RVU23D
2023-07-01$113.46$70.18RVU23C
2023-04-01$113.46$70.18RVU23B
2023-01-01$113.46$70.18RVU23A
2022-10-01$111.80$70.82RVU22D
2022-07-01$111.80$70.82RVU22C
2022-04-01$111.80$70.82RVU22B
2022-01-01$111.80$70.82RVU22A
2021-10-01$110.90$71.12RVU21D
2021-07-01$110.90$71.12RVU21C
2021-04-01$110.90$71.12RVU21B
2021-01-01$110.90$71.12RVU21A
2020-10-01$113.28$73.45RVU20D
2020-07-01$113.28$73.45RVU20C
2020-04-01$113.28$73.45RVU20B
2020-01-01$113.28$73.45RVU20A
2019-10-01$115.95$74.35RVU19D
2019-07-01$115.95$74.35RVU19C
2019-04-01$115.95$74.35RVU19B
2019-01-01$115.95$74.35RVU19A
2018-10-01$114.53$72.96RVU18D
2018-07-01$114.53$72.96RVU18C
2018-04-01$114.53$72.96RVU18B
2018-01-01$114.53$72.96RVU18AR1
2017-10-01$110.49$71.73RVU17D
2017-07-01$110.49$71.73RVU17C
2017-04-01$110.49$71.73RVU17B
2017-01-01$110.49$71.73RVU17A
2016-10-01$110.42$71.52RVU16D
2016-07-01$110.42$71.52RVU16C
2016-04-01$110.42$71.52RVU16B
2016-01-01$110.42$71.52RVU16A
2015-10-01$110.31$71.27RVU15D
2015-07-01$110.31$71.27RVU15C
2015-04-01$109.77$70.92RVU15B
2015-01-01$109.77$70.92RVU15A
2014-10-01$110.26$71.74RVU14D
2014-07-01$110.26$71.74RVU14C
2014-04-01$110.26$71.74RVU14B
2014-01-01$110.26$71.74RVU14A
2013-10-01$109.55$69.09RVU13D
2013-07-01$109.55$69.09RVU13C
2013-04-01$109.55$69.09RVU13B
2013-01-01$109.55$69.09RVU13AR

Price 95076 for an earlier date of service

Where the Idaho rate applies

Idaho is a Medicare payment area, not a city. Our Census mapping connects it to 235 cities and communities in Idaho. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Acequia
  • Albion
  • American Falls
  • Ammon
  • Arbon Valley
  • Arco
  • Arimo

Browse all communities in Idaho

95076 billing questions

When is 95076 appropriate instead of allergy skin testing?

Use 95076 when the clinician evaluates tolerance by administering the suspected food or medication orally in a monitored challenge. Skin testing, such as 95004 or 95018, records a different testing method.

Can 95079 be reported with 95076?

Yes. 95076 represents the initial testing interval, and 95079 is the add-on code for each additional 60 minutes of ingestion challenge testing.

What should the record support?

Document the substance administered, incremental challenge steps, elapsed testing time, monitoring findings, and any reaction or treatment. The record should show that an oral challenge was performed, rather than only a discussion or history review.

Is a food challenge the only service reported with 95076?

No. The code can describe an oral challenge involving a medication as well as a food. The documentation should make clear what substance was ingested and how the challenge was conducted.

Does 95076 cover an inhaled allergen challenge?

No. 95076 is for an ingested challenge; 95070 describes bronchial inhalation challenge testing.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 95076PPRRVU2026_Oct_nonQPP.csv, line 12,470 (RVU26D)
Geographic factors for IdahoGPCI2026.csv, line 47 (RVU26D)

Open CMS sourceHow we calculate rates

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