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CPT code 95131: Venom immunotherapy, two insect venoms2026 Medicare rate & RVUs in Washington, DC area

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, 2026One payment locality

CMS doesn’t publish a rate for 95131 in Washington, DC area.

Separate payment rules applyOffice (non-facility)
Separate payment rules applyHospital or facility

Check a contract rate as a % of Medicare · 95131 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 95131 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 95131 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 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.

How Washington, DC area compares for 95131

95131 in Washington, DC area vs other payment areas
  1. Washington, DC area · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Miami, FL · FloridaUnavailable
  4. Chicago, IL · IllinoisUnavailable
  5. Manhattan, NY · New YorkUnavailable
  6. Alaska · AlaskaUnavailable
  7. Alabama · AlabamaUnavailable

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

95131 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——
Madera, CACalifornia——

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

See 95131 in every payment locality

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.

Codes related to 95131

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

Codes related to 95131
CodeHow it relatesOffice range, Washington, DC area
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

How 95131 has changed in Washington, DC area

95131 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

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
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Separate payment rules applySeparate payment rules applyRVU26D
2026-07-01Separate payment rules applySeparate payment rules applyRVU26C
2026-04-01Separate payment rules applySeparate payment rules applyRVU26B
2026-01-01Separate payment rules applySeparate payment rules applyRVU26A
2025-10-01Separate payment rules applySeparate payment rules applyRVU25D
2025-07-01Separate payment rules applySeparate payment rules applyRVU25C
2025-04-01Separate payment rules applySeparate payment rules applyRVU25B
2025-01-01Separate payment rules applySeparate payment rules applyRVU25A
2024-10-01Separate payment rules applySeparate payment rules applyRVU24D
2024-07-01Separate payment rules applySeparate payment rules applyRVU24C
2024-04-01Separate payment rules applySeparate payment rules applyRVU24B
2024-03-09Separate payment rules applySeparate payment rules applyRVU24AR
2024-01-01Separate payment rules applySeparate payment rules applyRVU24A
2023-10-01Separate payment rules applySeparate payment rules applyRVU23D
2023-07-01Separate payment rules applySeparate payment rules applyRVU23C
2023-04-01Separate payment rules applySeparate payment rules applyRVU23B
2023-01-01Separate payment rules applySeparate payment rules applyRVU23A
2022-10-01Separate payment rules applySeparate payment rules applyRVU22D
2022-07-01Separate payment rules applySeparate payment rules applyRVU22C
2022-04-01Separate payment rules applySeparate payment rules applyRVU22B
2022-01-01Separate payment rules applySeparate payment rules applyRVU22A
2021-10-01Separate payment rules applySeparate payment rules applyRVU21D
2021-07-01Separate payment rules applySeparate payment rules applyRVU21C
2021-04-01Separate payment rules applySeparate payment rules applyRVU21B
2021-01-01Separate payment rules applySeparate payment rules applyRVU21A
2020-10-01Separate payment rules applySeparate payment rules applyRVU20D
2020-07-01Separate payment rules applySeparate payment rules applyRVU20C
2020-04-01Separate payment rules applySeparate payment rules applyRVU20B
2020-01-01Separate payment rules applySeparate payment rules applyRVU20A
2019-10-01Separate payment rules applySeparate payment rules applyRVU19D
2019-07-01Separate payment rules applySeparate payment rules applyRVU19C
2019-04-01Separate payment rules applySeparate payment rules applyRVU19B
2019-01-01Separate payment rules applySeparate payment rules applyRVU19A
2018-10-01Separate payment rules applySeparate payment rules applyRVU18D
2018-07-01Separate payment rules applySeparate payment rules applyRVU18C
2018-04-01Separate payment rules applySeparate payment rules applyRVU18B
2018-01-01Separate payment rules applySeparate payment rules applyRVU18AR1
2017-10-01Separate payment rules applySeparate payment rules applyRVU17D
2017-07-01Separate payment rules applySeparate payment rules applyRVU17C
2017-04-01Separate payment rules applySeparate payment rules applyRVU17B
2017-01-01Separate payment rules applySeparate payment rules applyRVU17A
2016-10-01Separate payment rules applySeparate payment rules applyRVU16D
2016-07-01Separate payment rules applySeparate payment rules applyRVU16C
2016-04-01Separate payment rules applySeparate payment rules applyRVU16B
2016-01-01Separate payment rules applySeparate payment rules applyRVU16A
2015-10-01Separate payment rules applySeparate payment rules applyRVU15D
2015-07-01Separate payment rules applySeparate payment rules applyRVU15C
2015-04-01Separate payment rules applySeparate payment rules applyRVU15B
2015-01-01Separate payment rules applySeparate payment rules applyRVU15A
2014-10-01Separate payment rules applySeparate payment rules applyRVU14D
2014-07-01Separate payment rules applySeparate payment rules applyRVU14C
2014-04-01Separate payment rules applySeparate payment rules applyRVU14B
2014-01-01Separate payment rules applySeparate payment rules applyRVU14A
2013-10-01Separate payment rules applySeparate payment rules applyRVU13D
2013-07-01Separate payment rules applySeparate payment rules applyRVU13C
2013-04-01Separate payment rules applySeparate payment rules applyRVU13B
2013-01-01Separate payment rules applySeparate payment rules applyRVU13AR

Price 95131 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

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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