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CMS RVU26D · Effective 2026-10-01

95149 Venom antigen preparation Medicare reimbursement rates in Pennsylvania

Reports allergen immunotherapy antigen preparation and provision for a patient receiving treatment with five or more distinct stinging-insect venoms. Compare 95149 office and facility rates across CMS payment localities in Pennsylvania.

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 95149 in Pennsylvania?

Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.

Office / nonfacility

$109.02–$123.44

2 of 2 localities have a supported rate.

Lowest: Rest Of Pennsylvania

Highest: Metropolitan Philadelphia

A spread of $14.42 per service.

Facility setting

$2.63–$2.79

2 of 2 localities have a supported rate.

Lowest: Rest Of Pennsylvania

Highest: Metropolitan Philadelphia

A spread of $0.16 per service.

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.

Find 95149 in your payment locality →

Allergy and immunology

About 95149: Preparation of multiple insect venom antigens

Reports allergen immunotherapy antigen preparation and provision for a patient receiving treatment with five or more distinct stinging-insect venoms.

This service covers the supervision of preparing and supplying venom antigens for allergen immunotherapy when the treatment includes five or more distinct stinging-insect venoms. An allergist or other qualified clinician typically arranges this work in an allergy practice; the prepared extracts may include venoms such as honeybee, yellow jacket, or hornet. The service concerns the antigen preparation and provision, not the injection given to the patient.

Choose this level based on the number of distinct venom types prepared for the patient, rather than the number of injections or visits. The record should support the venom types and the preparation and provision performed. CMS assigns physician fee schedule relative values for work, practice expense, and malpractice; the practice-expense value differs between office and facility settings. Report a separate, appropriate immunotherapy administration service when an injection is also given, supported by the service documentation.

Where the value comes from

  • Work RVU0.06 · 2%
  • Practice expense (office) RVU3.48 · 98%
  • Malpractice RVU0.01 · 0%

14.8K

Medicare services in 2024 · #1258 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.

95149 compared with similar codes

Office rates for Pennsylvania, from the same CMS release.

95148

Venom antigen preparation

Four insect venoms

$82.04–$92.84

Use 95148 when the prepared immunotherapy includes four distinct stinging-insect venoms. Use 95149 for five or more.

95165

Allergy extract preparation

Multidose vials, per dose

$16.12–$18.09

95149 identifies preparation and provision at the five-or-more stinging-insect venom level. 95165 is a different antigen-preparation service, not a venom-count substitute.

95134

Immntx 5 sting insects

No office rate

95134 represents the immunotherapy administration service for five or more stinging-insect venoms. 95149 represents preparation and provision of the venom antigens.

Compare 95149 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.

2 of 2 payment localities

Office and facility base rates · shared scale starting at $0

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95149 billing questions

How is 95149 different from 95148?

95149 is for preparation and provision involving five or more distinct stinging-insect venoms. 95148 is the adjacent level for four venoms.

Does 95149 include giving the injection?

No. It covers supervision of venom-antigen preparation and provision; report an appropriate injection service separately when an injection is administered.

Can 95149 be reported with 95134?

They represent different services: venom-antigen preparation and provision versus immunotherapy administration for five or more stinging-insect venoms. Report both when each service was performed and documented.

Is 95149 selected by the number of injection visits?

No. Select it according to the number of distinct venom types prepared, with this level representing five or more.

What documentation supports 95149?

Document the distinct stinging-insect venom types included and the preparation and provision service. The record should support that the service involved five or more venoms.

How does 95149 differ from 95165?

95149 is the level for five or more stinging-insect venoms. 95165 is used for allergen antigen preparation services outside this specific venom-count level.

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.

RVUs for 95149PPRRVU2026_Oct_nonQPP.csv, line 12,486 (RVU26D)