$84.46
95076 reports the initial ingestion challenge interval. Use 95079 for each additional 60 minutes of testing when the challenge continues.
On this page
CMS RVU26D · Effective 2026-10-01
95076 Ingestion challenge Medicare reimbursement rates in Delaware
Reports supervised oral challenge testing, such as a food or medication challenge, for the initial testing interval used to assess a suspected reaction. Compare 95076 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95076 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$122.44
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
$62.38
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Allergy testing
About 95076: Oral ingestion challenge, initial testing
Reports supervised oral challenge testing, such as a food or medication challenge, for the initial testing interval used to assess a suspected reaction.
An ingestion challenge involves giving a patient measured, sequential amounts of a suspected food or medication by mouth while observing for an allergic response. Allergists and other clinicians experienced in allergy evaluation commonly perform these challenges in an office or facility equipped to monitor the patient and respond to reactions. Examples include assessing whether a patient can tolerate a food or an oral medication after a history of possible allergy.
Report 95076 for the initial testing interval; when testing continues beyond that interval, 95079 is the add-on code for additional testing time. Documentation should identify the ingested substance, the incremental doses or challenge steps, the testing time, observations, and any symptoms or intervention. CMS physician fee schedule values for this service include physician work, practice expense, and malpractice components, with practice expense values differing between office and facility settings.
Where the value comes from
- Work RVU1.50 · 41%
- Practice expense (office) RVU2.13 · 58%
- Malpractice RVU0.06 · 2%
12.9K
Medicare services in 2024 · #1342 by national volume
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.
95076 compared with similar codes
Office rates for Delaware, from the same CMS release.
$39.18
95070 is for bronchial challenge by inhalation. Choose 95076 when the test substance is administered orally.
$18.86
95018 reports percutaneous and intradermal drug or biological testing; 95076 reports a monitored challenge by ingestion.
$3.61
95004 is percutaneous allergen testing, not an oral challenge assessing whether a patient tolerates an ingested substance.
Compare 95076 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
$122.44
Facility
$62.38
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95076 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
12,470
- Code
- 95076
- Physician work
- 1.50
- Practice expense
- 2.13
- Malpractice
- 0.06
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.50 | × 1.005 | 1.5075 |
| Practice expense | 2.13 | × 0.988 | 2.1044 |
| Malpractice | 0.06 | × 0.899 | 0.0539 |
| Total RVUs | 3.6659 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$122.44
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.5 | 1.005 |
| Practice expense | 2.13 | 0.988 |
| Malpractice | 0.06 | 0.899 |
(1.5 × 1.005 + 2.13 × 0.988 + 0.06 × 0.899) × $33.4009 = $122.44
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.5 | 1.005 |
| Practice expense | 0.31 | 0.988 |
| Malpractice | 0.06 | 0.899 |
(1.5 × 1.005 + 0.31 × 0.988 + 0.06 × 0.899) × $33.4009 = $62.38
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
95076 billing questions
When is 95076 appropriate instead of allergy skin testing?
Use 95076 when the clinician evaluates tolerance by administering the suspected food or medication orally in a monitored challenge. Skin testing, such as 95004 or 95018, records a different testing method.
Can 95079 be reported with 95076?
Yes. 95076 represents the initial testing interval, and 95079 is the add-on code for each additional 60 minutes of ingestion challenge testing.
What should the record support?
Document the substance administered, incremental challenge steps, elapsed testing time, monitoring findings, and any reaction or treatment. The record should show that an oral challenge was performed, rather than only a discussion or history review.
Is a food challenge the only service reported with 95076?
No. The code can describe an oral challenge involving a medication as well as a food. The documentation should make clear what substance was ingested and how the challenge was conducted.
Does 95076 cover an inhaled allergen challenge?
No. 95076 is for an ingested challenge; 95070 describes bronchial inhalation challenge testing.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,46795060,,Oph mucous membrane tests,A,,0.00,1.21,,1.21,NA,0.01,1.22,1.22,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,46895065,,Dir nsl mucous membrane test,A,,0.00,0.83,,0.83,NA,0.01,0.84,0.84,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,46995070,,Inhlj brncl challenge tstg,A,,0.00,1.16,,1.16,NA,0.03,1.19,1.19,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,47095076,,Ingest challenge ini 120 min,A,,1.50,2.13,,0.31,,0.06,3.69,1.87,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47195079,,Ingest challenge addl 60 min,A,,1.38,1.11,,0.29,,0.05,2.54,1.72,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47295115,,Immunotherapy one injection,A,,0.00,0.30,,0.30,NA,0.01,0.31,0.31,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,47395117,,Immunotherapy injections,A,,0.00,0.36,,0.36,NA,0.01,0.37,0.37,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503