CPT code 95120: Allergen immunotherapy, one injection with extract2026 Medicare rate & RVUs in Maryland
Reports one allergen immunotherapy injection with the allergenic extract included; Medicare assigns status I and uses different codes for the service.
CMS doesn’t publish an office rate for 95120 in Maryland.
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 95120 covers
95120 represents a professional allergen-immunotherapy service for administration of one injection, with the allergenic extract included. It is used for allergy-shot treatment in which a clinician administers prescribed allergen extract. The code distinguishes a single injection from services covering multiple injections; venom immunotherapy is identified separately through codes based on the number of insect venoms. Allergy specialists commonly provide this treatment in an outpatient office.
Medicare assigns status I to 95120, so it is not valid for Medicare reporting; Medicare uses different codes for the service. Medicare reporting separates the injection from antigen preparation: 95115 identifies one immunotherapy injection, and 95165 reports antigen preparation when applicable. Submit the Medicare codes that represent the administered injection and antigen preparation rather than 95120.
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 95120 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | Unavailable | Unavailable |
| Rest of Maryland | Unavailable | Unavailable |
| Washington, DC area | Unavailable | Unavailable |
How the 95120 rate is calculated
Each of 95120’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 · 95120
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense0.00
0.00 RVUs× 1.000 GPCI
Malpractice0.00
0.00 RVUs× 1.000 GPCI
Adjusted RVUs
0.0000
Conversion factor
$33.4009
Medicare rate
$0.00
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95120
95120 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 · 95120
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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95120 isn’t priced in this setting.
95120 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95115Allergy shotSingle injection, extract not included
- 95120 includes allergenic extract with one injection; 95115 represents one injection without the extract included. Medicare reporting separates the injection and antigen preparation.
- 95125Allergen immunotherapyTwo or more injections
- Both include allergenic extract, but 95125 describes two or more injections rather than one.
- 95130Venom immunotherapyOne insect venom
- 95130 identifies immunotherapy for one insect venom. 95120 describes one allergen immunotherapy injection with extract.
- 95165Allergy extract preparationMultidose vials, per dose
- 95165 reports antigen preparation, not administration of a single immunotherapy injection.
95120 billing questions
How does 95120 differ from 95115?
95120 includes the allergenic extract with one injection. 95115 represents one immunotherapy injection without the extract included.
Does Medicare accept 95120?
No. Medicare assigns status I, meaning 95120 is not valid for Medicare reporting; Medicare uses different codes for the service.
How many injections does 95120 describe?
It describes one allergen immunotherapy injection. 95125 covers the service when two or more injections are given with extract.
How is insect-venom immunotherapy distinguished?
Venom immunotherapy uses separate codes based on the number of insect venoms; 95130 is for one insect venom.
Does 95120 include allergenic extract?
Yes. The extract is included in the service; Medicare reporting uses separate codes for the injection and antigen preparation.
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
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