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CPT code 95131: Venom immunotherapy, two insect venoms2026 Medicare rate & RVUs

A venom-allergy immunotherapy visit addressing two stinging-insect venoms; Medicare does not accept 95131 and uses a different code for reporting and payment.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare rate · 95131

Venom immunotherapy, two insect venoms

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 95131 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 95131 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 95131 covers

95131 identifies a venom-allergy immunotherapy visit involving two stinging-insect venoms. An allergy specialist reports it for treatment administered during a patient's care for insect-venom allergy. The code distinguishes the visit by the number of venoms addressed, rather than by the count of injections. It is separate from codes describing preparation and provision of allergen extracts.

Medicare assigns status I to 95131: Medicare does not accept this CPT code and uses a different code to report and pay for the service. Within the CPT venom-immunotherapy family, the neighboring codes distinguish visits by the number of stinging-insect venoms involved. Antigen preparation and provision are represented separately from the venom-immunotherapy visit.

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 95131 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

95131 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

95131 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.

View every state and territory as a table
95131 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 95131 rate is calculated

Each of 95131’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 · 95131

RVUs × geographic indexes × conversion factor

Office or facility?

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 95131

95131 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 · 95131

Which rate does Medicare pay?

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

POS 11 · non-facility rate · national

—

95131 isn’t priced in this setting.

95131 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 95131

    Venom immunotherapy, two insect venoms0 wRVU

    Not priced

  • 95130

    Venom immunotherapy, one insect venom0 wRVU

    Not priced

  • 95132

    Venom immunotherapy, three venoms0 wRVU

    Not priced

  • 95117

    Allergy shots, two or more injections, extract not included0 wRVU

    $12.36

  • 95146

    Venom antigen preparation, two venom types0.06 wRVU

    $62.46

How to choose

95130Venom immunotherapyOne insect venom
95130 identifies a visit involving one stinging-insect venom; 95131 identifies a visit involving two.
95132Venom immunotherapyThree venoms
95132 identifies a visit involving three stinging-insect venoms; 95131 identifies a visit involving two.
95117Allergy shotsTwo or more injections, extract not included
95117 describes allergen immunotherapy involving two or more injections. 95131 distinguishes venom immunotherapy by the number of stinging-insect venoms.
95146Venom antigen preparationTwo venom types
95146 concerns antigen preparation and provision for two stinging-insect venoms; 95131 identifies the venom-immunotherapy visit.

Codes related to 95131

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

Codes related to 95131
CodeHow it relatesNational office range
Same family
95130Venom immunotherapy, one insect venomSibling venom-immunotherapy visit code for one stinging-insect venom.No office rate
95132Venom immunotherapy, three venomsSibling venom-immunotherapy visit code for three stinging-insect venoms.No office rate
95133Insect immunotherapy, four stinging insectsSibling venom-immunotherapy visit code for four stinging-insect venoms.No office rate
95134Venom immunotherapy, five insect typesSibling venom-immunotherapy visit code for five stinging-insect venoms.No office rate

95131 billing questions

When is 95131 selected instead of 95130 or 95132?

95131 identifies a visit involving two stinging-insect venoms. 95130 is for one, and 95132 is for three.

Is 95131 valid for Medicare claims?

No. Medicare assigns status I to 95131 and uses a different code to report and pay for the service.

Does 95131 include venom extract preparation and provision?

No. The venom-immunotherapy visit is separate from codes for antigen preparation and provision.

How are units determined?

The code identifies a visit involving two stinging-insect venoms; it is not selected by counting injections alone.

What should the record support?

Document the venom immunotherapy provided and identify the two stinging-insect venoms involved.

How does 95131 differ from 95117?

95131 distinguishes a venom-immunotherapy visit by the number of stinging-insect venoms. 95117 describes allergen immunotherapy involving two or more injections.

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

Open CMS sourceHow we calculate rates

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