$36.92
Choose 95065 for direct testing of the nasal lining; choose 95060 when the test targets the ophthalmic mucous membrane.
On this page
CMS RVU26D · Effective 2026-10-01
95065 Nasal allergy test Medicare reimbursement rates in Tennessee
Reports direct testing of the nasal lining for an allergen-related response, commonly used when evaluating suspected allergic rhinitis or nasal triggers. Compare 95065 office and facility rates across CMS payment localities in Tennessee.
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 95065 in Tennessee?
Tennessee 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
$25.38
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
No supported rate
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 95065: Direct nasal allergen response test
Reports direct testing of the nasal lining for an allergen-related response, commonly used when evaluating suspected allergic rhinitis or nasal triggers.
An allergist or other clinician evaluating allergic rhinitis may apply an allergen directly to the nasal lining and assess the local response. This target-organ test can help evaluate a suspected nasal trigger; it is distinct from testing reactivity on the skin or challenging the lower airways. It is typically performed in an outpatient allergy setting.
Report 95065 for the direct nasal mucous-membrane testing service, rather than for skin testing or bronchial challenge. Documentation should identify the clinical reason, substances tested, testing method, observed nasal response, and personnel involved. CMS classifies 95065 as technical-component-only: its valuation includes no physician work, and a separate code covers interpretation. Treat the test and its professional interpretation as separately represented services, not as a single global service.
CMS billing rules for 95065
- Professional and technical components
- Technical-component-only code: a separate code covers interpretation.
Where the value comes from
- Work RVU0.00 · 0%
- Practice expense (office) RVU0.83 · 99%
- Malpractice RVU0.01 · 1%
65
Medicare services in 2024 · #5192 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.
95065 compared with similar codes
Office rates for Tennessee, from the same CMS release.
$35.76
95065 concerns a nasal mucous-membrane response. 95070 is for inhalation bronchial challenge testing.
$3.25
95004 reports percutaneous skin testing with allergenic extracts. It does not describe direct nasal mucous-membrane testing.
$6.89
95024 reports intracutaneous allergen testing. Use 95065 when the testing is performed directly at the nasal lining.
Compare 95065 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
Tennessee →
Office / nonfacility
$25.38
Facility
Unavailable
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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 95065 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
12,468
- Code
- 95065
- Physician work
- 0.00
- Practice expense
- 0.83
- Malpractice
- 0.01
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.00 | × 1.000 | 0.0000 |
| Practice expense | 0.83 | × 0.909 | 0.7545 |
| Malpractice | 0.01 | × 0.537 | 0.0054 |
| Total RVUs | 0.7598 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$25.38
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0 | 1 |
| Practice expense | 0.83 | 0.909 |
| Malpractice | 0.01 | 0.537 |
(0 × 1 + 0.83 × 0.909 + 0.01 × 0.537) × $33.4009 = $25.38
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.
95065 billing questions
How does 95065 differ from 95060?
95065 is for direct testing of the nasal lining. 95060 is for testing the ophthalmic mucous membrane.
Is interpretation included in 95065?
No. CMS identifies 95065 as technical-component-only; a separate code covers interpretation.
How does this differ from 95070?
95065 evaluates a response at the nasal lining. 95070 is used for inhalation bronchial challenge testing.
What documentation supports 95065?
Record the reason for nasal testing, substances tested, method, observed response, and personnel involved.
Should 95065 be selected instead of skin testing?
Use 95065 for direct nasal mucous-membrane testing. Percutaneous and intracutaneous allergy tests use different codes, such as 95004 and 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 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.
12,46595052,,Photo patch tests,A,,0.00,0.17,,0.17,NA,0.01,0.18,0.18,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,46695056,,Photo tests,A,,0.00,1.53,,1.53,NA,0.02,1.55,1.55,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,46795060,,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
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780