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95079 Ingest challenge addl 60 min

What 95079 is

CMS fee schedule short descriptor: Ingest challenge addl 60 min.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 95079 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)1.381.110.052.54$84.84
Facility (hospital, ASC)1.380.290.051.72$57.45

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Add-on code: global period of the primary procedure applies.

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Medically Unlikely Edit (MUE)

Medicare caps 95079 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Clinical: Society Comment. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 95079? These codes are bundled into it

95079 is a Column 1 code in 159 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
0591THlth&wb coaching indiv 1st1 - modifier may bypassCheck pair
0592THlth&wb coaching indiv f-up1 - modifier may bypassCheck pair
0593THlth&wb coaching group1 - modifier may bypassCheck pair
36591Draw blood off venous device0 - no modifier bypassCheck pair
36592Collect blood from picc0 - no modifier bypassCheck pair
96160Pt-focused hlth risk assmt1 - modifier may bypassCheck pair
96161Caregiver health risk assmt1 - modifier may bypassCheck pair
96523Irrig drug delivery device0 - no modifier bypassCheck pair
99202Office o/p new sf 15 min1 - modifier may bypassCheck pair
99203Office o/p new low 30 min1 - modifier may bypassCheck pair
99204Office o/p new mod 45 min1 - modifier may bypassCheck pair
99205Office o/p new hi 60 min1 - modifier may bypassCheck pair
99211Off/op est may x req phy/qhp1 - modifier may bypassCheck pair
99212Office o/p est sf 10 min1 - modifier may bypassCheck pair
99213Office o/p est low 20 min1 - modifier may bypassCheck pair
99214Office o/p est mod 30 min1 - modifier may bypassCheck pair
99215Office o/p est hi 40 min1 - modifier may bypassCheck pair
992211st hosp ip/obs sf/low 401 - modifier may bypassCheck pair
992221st hosp ip/obs moderate 551 - modifier may bypassCheck pair
992231st hosp ip/obs high 751 - modifier may bypassCheck pair
99231Sbsq hosp ip/obs sf/low 251 - modifier may bypassCheck pair
99232Sbsq hosp ip/obs moderate 351 - modifier may bypassCheck pair
99233Sbsq hosp ip/obs high 501 - modifier may bypassCheck pair
99234Hosp ip/obs sm dt sf/low 451 - modifier may bypassCheck pair
99235Hosp ip/obs same date mod 701 - modifier may bypassCheck pair
99236Hosp ip/obs same date hi 851 - modifier may bypassCheck pair
99238Hosp ip/obs dschrg mgmt 30/<1 - modifier may bypassCheck pair
99239Hosp ip/obs dschrg mgmt >301 - modifier may bypassCheck pair
99242Off/op consltj new/est sf 201 - modifier may bypassCheck pair
99243Off/op cnsltj new/est low 301 - modifier may bypassCheck pair

Showing 30 of 159 column 2 codes. Use the pair checker for any specific combination.

95079 is bundled into these codes

95079 appears as a Column 2 code in 18 active edits. Reported with one of these Column 1 codes on the same date of service, 95079 is the code that denies.

Column 1 codeShort descriptionModifier indicator
95115Immunotherapy one injection1Check pair
95117Immunotherapy injections1Check pair
95120Immunotherapy one injection1Check pair
95125Immunotherapy 2/> injections1Check pair
95130Immntx 1 sting insect1Check pair
95131Immntx 2 sting insects1Check pair
95132Immntx 3 sting insects1Check pair
95133Immntx 4 sting insects1Check pair
95134Immntx 5 sting insects1Check pair
95144Antigen therapy services1Check pair
95145Antigen therapy services1Check pair
95146Antigen therapy services1Check pair
95147Antigen therapy services1Check pair
95148Antigen therapy services1Check pair
95149Antigen therapy services1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.