Allergy testing: how much does Medicare pay?

Nationally, the Q3 2026 Physician Fee Schedule pays $3.67 in an office (non-facility) setting and $3.67 in a facility setting for 95004. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.

Procedure · Updated Aug 1, 2026

Allergy testing: CPT code and Medicare rate

Skin prick testing to identify specific triggers behind allergic rhinitis, asthma, eczema, or suspected food allergy.

Also called: skin prick test, allergy skin test, scratch test.

Usually billed as

95004 Skin Prick Allergy Testing

Office (non-facility): $3.67
Facility: $3.67

National amounts for the Q3 2026 release (July 1 – September 30, 2026), using geographic index values of 1.000. Your local rate differs — open the code page for the locality breakdown.

This code is billed per test administered, so a panel covering many allergens produces a multiple of the single-test amount.

Common questions

Allergy testing: which code is it?: 95004 — Skin Prick Allergy Testing. Skin prick testing to identify specific triggers behind allergic rhinitis, asthma, eczema, or suspected food allergy.
Allergy testing: how much does Medicare pay?: Nationally, the Q3 2026 Physician Fee Schedule pays $3.67 in an office (non-facility) setting and $3.67 in a facility setting for 95004. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.
Allergy testing: what else affects the billing?: This code is billed per test administered, so a panel covering many allergens produces a multiple of the single-test amount.

Need the rate where you practice?

Every code page carries the full locality breakdown, the RVU and GPCI inputs, and the release that answered.

Open the code page

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All procedures How Medicare pays Office vs. facility rates Check a medical bill

This page maps everyday language to the code a claim normally carries. It is general information about how Medicare prices a service, not coding advice for a specific claim — the correct code always depends on what was actually documented and performed.

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