Billing code 95146: Venom antigen preparationMedicare rate & RVUs in Texas
Reports allergist-supervised preparation and provision of allergen immunotherapy antigens for treatment plans involving two distinct stinging-insect venoms.
Medicare pays $57.03–$65.91 for 95146 in the office in Texas, from Beaumont to Austin. 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.
On this page 9 sections
What 95146 covers
An allergist or allergy practice reports this service for the professional supervision involved in preparing and providing immunotherapy antigens for two distinct stinging-insect venoms. It concerns the venom extracts supplied for a patient’s desensitization regimen, not the injection visit itself. The service is typically part of outpatient allergy care, with the treating allergist determining the venom immunotherapy plan and the practice preparing or arranging the prescribed extracts.
Choose this code when the preparation and provision service covers two venom types; the count is based on venoms, not injection sites or the number of shots given. Documentation should identify the prescribed venom immunotherapy and support that two distinct venoms were prepared or provided. This code represents antigen preparation and provision, so it should not stand in for the separate service of administering venom injections. CMS facts supplied for this code list no additional payment rules.
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 95146 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$57.03 to $65.91
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $65.91 | $2.66 |
| Beaumont | $57.03 | $2.62 |
| Brazoria | $61.86 | $2.61 |
| Dallas | $62.19 | $2.64 |
| Fort Worth | $61.59 | $2.64 |
| Galveston | $62.00 | $2.63 |
| Houston | $62.18 | $2.81 |
| Rest Of Texas | $59.36 | $2.62 |
How the 95146 rate is calculated
Each of 95146’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 · 95146
RVUs × geographic indexes × conversion factor
Work0.06
0.06 RVUs× 1.000 GPCI
Practice expense1.80
1.80 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.8700
Conversion factor
$33.4009
Medicare rate
$62.46
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95146
95146 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 · 95146
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$62.46
- Non-facility (office)
- $62.46
- Facility
- $2.67
Higher because the practice carries its own overhead.
95146 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95131Immntx 2 sting insects
- 95131 represents the injection service for immunotherapy involving two stinging-insect venoms. This code represents preparation and provision of the venom antigens.
- 95145Venom antigen
- Use 95145 when the antigen preparation and provision service involves one stinging-insect venom; this code covers two.
- 95147Antigen preparation
- Use 95147 when the antigen preparation and provision service involves three stinging-insect venoms; this code covers two.
- 95165Allergy extract preparation
- 95165 applies to nonvenom allergen antigens. This code is specific to preparation and provision involving two stinging-insect venoms.
95146 billing questions
How is this code distinguished from 95145 or 95147?
This code is for antigen preparation and provision involving two stinging-insect venoms. Use 95145 for one venom and 95147 for three.
Does this code include the venom injection?
No. It represents supervision of venom antigen preparation and provision, not administration. When injections are given, the applicable injection service is selected separately.
How should the venom count be determined?
Count the distinct stinging-insect venoms represented in the prepared or provided immunotherapy antigens. The code covers two venom types, not two injections.
Is this the right code for nonvenom allergy extracts?
No. This code is for stinging-insect venom antigens. Code 95165 is used for preparation and provision of nonvenom allergen antigens.
What documentation supports reporting this service?
The record should support the prescribed venom immunotherapy and identify the two distinct venom antigens prepared or provided for the patient.
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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