CPT code 95079: Ingestion challenge, each additional 60 minutes2026 Medicare rate & RVUs in Maine
Reports each additional 60 minutes of supervised oral ingestion challenge testing after the initial challenge period, such as evaluation of suspected food or drug reactions.
Medicare pays $81.24–$83.89 for 95079 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 95079 covers
This code accounts for additional time spent administering a supervised oral challenge in sequential, incremental doses and observing for a reaction. Allergy specialists commonly use ingestion challenges to assess suspected food allergy or drug allergy, or to determine whether a patient can tolerate a food or medication. The service may take place in an office or facility equipped to monitor the patient during the challenge.
Report 95079 for each additional 60 minutes after the initial ingestion challenge service, and only with the primary challenge code 95076. Documentation should support the challenge items and dose sequence, monitoring and response, and the additional testing time. CMS classifies 95079 as an add-on code: it must be billed with the primary procedure, and its payment is made within that procedure's global period.
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.
Where 95079 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $81.24 | $56.04 |
| Southern Maine, ME | $83.89 | $56.75 |
How the 95079 rate is calculated
Each of 95079’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 · 95079
RVUs × geographic indexes × conversion factor
Work1.38
1.38 RVUs× 1.000 GPCI
Practice expense1.11
1.11 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
2.5400
Conversion factor
$33.4009
Medicare rate
$84.84
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95079
The CMS indicators that decide how 95079 is paid alongside other services.
CMS payment indicators · 95079
Ingestion challenge, each additional 60 minutes
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
95079 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95076Ingestion challengeInitial 120 minutes
- 95076 covers the initial ingestion challenge period; 95079 accounts for each additional 60 minutes and must be reported with 95076.
- 95070Bronchial challengeTechnical testing
- 95070 is for bronchial inhalation challenge testing. Use 95079 only for additional time in an oral ingestion challenge.
- 95018Drug allergy testingPercutaneous and intracutaneous tests
- 95018 describes percutaneous and intradermal testing for drugs or biological substances; 95079 applies to additional time during a supervised oral ingestion challenge.
95079 billing questions
Can 95079 be billed without 95076?
No. Report 95079 only with the primary ingestion challenge code 95076.
How many units of 95079 should be reported?
Report a unit for each additional 60 minutes of ingestion challenge testing beyond the initial service. Document the additional testing time.
What documentation supports additional challenge time?
Document the items and incremental doses administered, patient monitoring and response, and the time spent in the additional challenge period.
Is 95079 used for an inhaled challenge?
No. It is for additional time in an oral ingestion challenge. Inhalation bronchial challenge testing is represented by a different service, such as 95070.
Does 95079 have a separate global period?
No separate period is described for this add-on. CMS specifies that it is paid within the primary procedure's global period.
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.
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