CPT code 95921: Autonomic testing, parasympathetic function2026 Medicare rate & RVUs in Washington
Reports autonomic testing of parasympathetic function, such as heart-rate responses to deep breathing or a Valsalva maneuver, during evaluation of autonomic symptoms.
Medicare pays $93.40–$104.90 for 95921 in the office in Washington, from Rest of Washington to King County, WA. 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 95921 covers
This service assesses parasympathetic control of heart rate, commonly by recording the heart-rate response to deep breathing or a Valsalva maneuver. Neurologists and clinicians specializing in autonomic disorders may order it when evaluating suspected autonomic neuropathy or symptoms such as unexplained lightheadedness or fainting. Testing is generally performed in an autonomic or neurophysiology laboratory with ECG monitoring and trained staff.
Report 95921 when the documented service evaluates parasympathetic function; the record should identify the tests performed, the clinical indication, recorded findings, and the interpreting clinician’s conclusions. It may be billed globally when one provider or entity supplies both the testing resources and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. CMS separately prices these component claims.
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 95921 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| King County, WA | $104.90 | Unavailable |
| Rest of Washington | $93.40 | Unavailable |
How the 95921 rate is calculated
Each of 95921’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 · 95921
RVUs × geographic indexes × conversion factor
Work0.88
0.88 RVUs× 1.000 GPCI
Practice expense1.78
1.78 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
2.7000
Conversion factor
$33.4009
Medicare rate
$90.18
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95921
The CMS indicators that decide how 95921 is paid alongside other services.
CMS payment indicators · 95921
Autonomic testing, parasympathetic function
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95921 without 26 · national office
$90.18
Autonomic testing, parasympathetic function
95921-26 · Professional component
$44.09
Pays only the interpretation and report.
95921 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95922Autonomic testingAdrenergic function
- 95921 evaluates parasympathetic function, including heart-rate responses to maneuvers such as deep breathing. 95922 evaluates vasomotor adrenergic function.
- 95923Sweat function testSudomotor testing
- Choose 95921 for parasympathetic testing; 95923 describes sudomotor testing of sweat-related autonomic function.
- 95924Autonomic testingCombined tilt-table protocol
- 95924 describes combined parasympathetic and sympathetic adrenergic testing with tilt, rather than parasympathetic testing alone.
95921 billing questions
When should 95921 be selected instead of 95922?
Use 95921 for testing of parasympathetic function, such as heart-rate responses to deep breathing or Valsalva. Code 95922 addresses vasomotor adrenergic function.
How does 95921 differ from 95924?
Code 95921 represents parasympathetic testing. Code 95924 is for combined parasympathetic and sympathetic adrenergic testing that includes tilt testing.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service with equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 95921?
Document the clinical reason for testing, the parasympathetic maneuvers performed, the recorded responses, and the interpretation. The record should make clear that the service evaluated parasympathetic function.
Is 95923 another code for parasympathetic testing?
No. Code 95923 is for sudomotor autonomic testing, which assesses sweat-related function; 95921 evaluates parasympathetic function.
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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