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

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 Houston, TX, Medicare pays $123.91 for 95076 in the office and $63.54 when it’s performed in a hospital or facility.

$123.91Office (non-facility)
$63.54Hospital or facility
+0.5%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 Houston, TX
  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 Houston, TX 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. Houston, TX pays $123.91. The RVUs are the same everywhere; the geographic indexes change the dollars.

95076 in Houston, TX vs other payment areas
  1. Houston, TX · this page$123.91
  2. Austin, TX · Texas$127.25+$3.34
  3. Beaumont, TX · Texas$116.70−$7.21
  4. Brazoria, TX · Texas$122.57−$1.34
  5. Dallas, TX · Texas$123.13−$0.78
  6. Fort Worth, TX · Texas$122.45−$1.46
  7. Galveston, TX · Texas$122.81−$1.10

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

Every other payment area

95076 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$119.43$61.74
Los Angeles, CACalifornia$137.65$65.74
Washington, DC areaDistrict of Columbia$138.84$67.23
Miami, FLFlorida$129.23$65.95
Chicago, ILIllinois$126.55$65.46
Manhattan, NYNew York$139.16$68.52
AlaskaAlaska$152.02$87.28
AlabamaAlabama$113.49$60.30

95076 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 95076 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work1.50× 1.0081.5120
Practice expense2.13× 0.9932.1151
Malpractice0.06× 1.3760.0826
Total RVUs3.7096
Conversion factor× 33.4009

Office rate, Houston, TX$123.91

Office: (1.5 × 1.008 + 2.13 × 0.993 + 0.06 × 1.376) × $33.4009 = $123.91

Facility: (1.5 × 1.008 + 0.31 × 0.993 + 0.06 × 1.376) × $33.4009 = $63.54

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.

Codes related to 95076

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 95076
CodeHow it relatesOffice range, Houston, TX
Add-on codes
95079Ingestion challenge, each additional 60 minutesAdd-on code for each additional 60 minutes of ingestion challenge testing.$85.58
Used instead
95070Bronchial challenge, technical testingUsed for bronchial inhalation challenge testing rather than an orally administered challenge.$39.85
95018Drug allergy testing, percutaneous and intracutaneous testsDrug allergy skin testing uses percutaneous or intradermal testing, not an oral ingestion challenge.$19.10
95004Allergy skin prick test, percutaneous, immediate reaction, per testPercutaneous allergen testing evaluates skin reactivity rather than tolerance during oral ingestion.$3.78

How 95076 has changed in Houston, TX

95076 · Office / nonfacility

$123.91

Effective 2026-10-01

The base rate is $1.38 higher than on 2025-10-01, moving from $122.53 to $123.91 (1.1%).

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

    $122.53changed to$123.91

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $124.89changed to$122.53

    • 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

    $122.85changed to$124.89

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $124.58changed to$122.85

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.04 changed to 2.14
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $124.83changed to$124.58

    • 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
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $123.45changed to$124.83

    • 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

    $124.16changed to$123.45

    • 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
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $125.37changed to$124.16

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.87 changed to 1.81
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $123.77changed to$125.37

    • 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

    $119.23changed to$123.77

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.72 changed to 1.83
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $119.09changed to$119.23

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.73 changed to 1.72
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $118.82changed to$119.09

    • 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

    $118.23changed to$118.82

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $118.39changed to$118.23

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.73 changed to 1.72
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $117.50changed to$118.39

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.89 changed to 1.73
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $117.50

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$123.91$63.54RVU26D
2026-07-01$123.91$63.54RVU26C
2026-04-01$123.91$63.54RVU26B
2026-01-01$123.91$63.54RVU26A
2025-10-01$122.53$72.24RVU25D
2025-07-01$122.53$72.24RVU25C
2025-04-01$122.53$72.24RVU25B
2025-01-01$122.53$72.24RVU25A
2024-10-01$124.89$74.14RVU24D
2024-07-01$124.89$74.14RVU24C
2024-04-01$124.89$74.14RVU24B
2024-03-09$124.89$74.14RVU24AR
2024-01-01$122.85$72.93RVU24A
2023-10-01$124.58$75.35RVU23D
2023-07-01$124.58$75.35RVU23C
2023-04-01$124.58$75.35RVU23B
2023-01-01$124.58$75.35RVU23A
2022-10-01$124.83$76.76RVU22D
2022-07-01$124.83$76.76RVU22C
2022-04-01$124.83$76.76RVU22B
2022-01-01$124.83$76.76RVU22A
2021-10-01$123.45$76.77RVU21D
2021-07-01$123.45$76.77RVU21C
2021-04-01$123.45$76.77RVU21B
2021-01-01$123.45$76.77RVU21A
2020-10-01$124.16$78.51RVU20D
2020-07-01$124.16$78.51RVU20C
2020-04-01$124.16$78.51RVU20B
2020-01-01$124.16$78.51RVU20A
2019-10-01$125.37$78.68RVU19D
2019-07-01$125.37$78.68RVU19C
2019-04-01$125.37$78.68RVU19B
2019-01-01$125.37$78.68RVU19A
2018-10-01$123.77$77.14RVU18D
2018-07-01$123.77$77.14RVU18C
2018-04-01$123.77$77.14RVU18B
2018-01-01$123.77$77.14RVU18AR1
2017-10-01$119.23$75.78RVU17D
2017-07-01$119.23$75.78RVU17C
2017-04-01$119.23$75.78RVU17B
2017-01-01$119.23$75.78RVU17A
2016-10-01$119.09$75.51RVU16D
2016-07-01$119.09$75.51RVU16C
2016-04-01$119.09$75.51RVU16B
2016-01-01$119.09$75.51RVU16A
2015-10-01$118.82$75.08RVU15D
2015-07-01$118.82$75.08RVU15C
2015-04-01$118.23$74.70RVU15B
2015-01-01$118.23$74.70RVU15A
2014-10-01$118.39$75.23RVU14D
2014-07-01$118.39$75.23RVU14C
2014-04-01$118.39$75.23RVU14B
2014-01-01$118.39$75.23RVU14A
2013-10-01$117.50$72.15RVU13D
2013-07-01$117.50$72.15RVU13C
2013-04-01$117.50$72.15RVU13B
2013-01-01$117.50$72.15RVU13AR

Price 95076 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

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 Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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