Billing code 95018: Drug allergy testingMedicare rate & RVUs
Reports immediate-reaction skin testing for suspected drug or biologic allergy using percutaneous and/or intracutaneous methods, with interpretation and a report.
Medicare pays $19.04 for 95018 nationally in the office and $6.01 in a hospital or facility. Local office rates run $16.90–$25.60.
Medicare rate · 95018
Drug allergy testing
Swap in your local Medicare rate.
- Work RVUs
- 0.14
- Total RVUs
- 0.57
- Global days
- XXX
National rate · 2026
$19.04
Office setting, before claim adjustments.
See every locality for 95018 → · 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.
On this page 10 sections
What 95018 covers
An allergist or other qualified clinician uses percutaneous and/or intracutaneous testing to evaluate a suspected immediate hypersensitivity reaction to a drug or biological product. Testing may be considered when a medication allergy history needs clinical evaluation, such as before deciding whether a patient can receive a needed antibiotic. The code covers a combination of the two skin-test methods; it is specific to drugs and biologicals rather than environmental allergen extracts.
Report the number of tests performed, and retain documentation identifying the agents and test methods, the results, and the clinician’s interpretation and report. Interpretation and reporting are part of the service, rather than separate services for the same tests. Under the Medicare Physician Fee Schedule, payment is based on work, practice expense, and malpractice relative value units; the practice-expense valuation differs between office and facility settings. The supplied CMS rules list no code-specific payment adjustments.
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 95018 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$16.90 to $25.60
109 of 109 payment localities
95018 rates by state
Office rate range in each state. Select a state to see its payment localities.
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Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$16.90
$22.96
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $22.14 | 1 |
| AL | $17.14 | 1 |
| AR | $16.90 | 1 |
| AZ | $18.56 | 1 |
| CA | $20.31–$25.60 | 29 |
| CO | $19.92 | 1 |
| CT | $20.28 | 1 |
| DC | $21.83 | 1 |
| DE | $18.86 | 1 |
| FL | $18.59–$20.12 | 3 |
| GA | $17.59–$19.34 | 2 |
| GU | $20.82 | 1 |
| HI | $20.82 | 1 |
| IA | $17.64 | 1 |
| ID | $17.74 | 1 |
| IL | $18.01–$19.71 | 4 |
| IN | $17.84 | 1 |
| KS | $17.53 | 1 |
| KY | $17.45 | 1 |
| LA | $17.41–$18.26 | 2 |
| MA | $19.79–$21.91 | 2 |
| MD | $19.23–$21.83 | 3 |
| ME | $17.79–$18.79 | 2 |
| MI | $17.86–$18.78 | 2 |
| MN | $19.21 | 1 |
| MO | $17.09–$18.37 | 3 |
| MS | $17.00 | 1 |
| MT | $19.04 | 1 |
| NC | $17.98 | 1 |
| ND | $18.84 | 1 |
| NE | $17.75 | 1 |
| NH | $19.57 | 1 |
| NJ | $20.55–$21.60 | 2 |
| NM | $17.94 | 1 |
| NV | $19.00 | 1 |
| NY | $18.24–$22.28 | 5 |
| OH | $17.82 | 1 |
| OK | $17.46 | 1 |
| OR | $18.88–$20.58 | 2 |
| PA | $17.87–$19.76 | 2 |
| PR | $19.19 | 1 |
| RI | $19.55 | 1 |
| SC | $17.92 | 1 |
| SD | $18.82 | 1 |
| TN | $17.61 | 1 |
| TX | $17.75–$19.82 | 8 |
| UT | $18.16 | 1 |
| VA | $18.70–$21.83 | 2 |
| VI | $19.19 | 1 |
| VT | $18.73 | 1 |
| WA | $19.76–$22.40 | 2 |
| WI | $18.22 | 1 |
| WV | $17.34 | 1 |
| WY | $18.95 | 1 |
How the 95018 rate is calculated
Each of 95018’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 · 95018
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.14Practice expense 0.42Malpractice 0.01
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95018
95018 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 · 95018
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
Non-facility (office) rate · national
$19.04
The facility rate would be $6.01 (+$13.03). In a facility, the facility bills its own costs separately.
95018 compared with similar codes
Compare codes
95018 vs 95017 vs 95004 vs 95024: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95017Venom testing
- 95018 is for drug or biologic allergy testing; 95017 is used for venom testing.
- 95004Allergy skin prick test
- 95004 describes percutaneous tests with allergenic extracts. Choose 95018 when testing drugs or biologicals, including when percutaneous testing is part of a combination of methods.
- 95024Intradermal allergy test
- 95024 is for intracutaneous tests with allergenic extracts. 95018 covers drug or biologic testing using intracutaneous testing alone or with percutaneous testing.
95018 billing questions
When should 95018 be chosen over 95017?
Use 95018 for drug or biological products. Code 95017 is the related testing code for venom allergy testing.
Can percutaneous and intracutaneous methods be reported together under 95018?
Yes. The code covers any combination of these methods for drug or biologic testing; report the number of tests performed.
Is interpretation separately billable?
Test interpretation and the report are included in 95018. Document the results and the clinician’s interpretation in the record.
What documentation supports the number of tests?
Record the drug or biological agents tested, the methods used, and the individual test results. The reported number should reflect the tests actually performed.
Is 95018 for environmental allergen testing?
No. It is for immediate-reaction testing with drugs or biologicals. Testing with allergenic extracts is represented by other allergy-testing codes, such as 95004 or 95024.
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
Show the CMS file lines behind this rate
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