How much does Medicare pay for CPT 95250?

Medicare allowed an average of $152.88 per service and paid $116.70 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $317.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95250?

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment. It was billed 21,774 times to 16,289 Medicare beneficiaries by 533 providers in 2024.

Which specialty bills 95250 most?

Endocrinology, with 14,433 services from 321 clinicians. Next are Internal Medicine, Nurse Practitioner, Family Practice.

CPT 95250

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with provider supplied equipment

$152.88Medicare-allowed amount per service, averaged across 21,774 services

Providers submitted

$317.75

Asking price, not received

Medicare allowed

$152.88

The fee schedule figure

Medicare paid

$116.70

Balance is patient coinsurance

Providers submitted an average of $317.75 for this code and Medicare allowed $152.88 — 2.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $116.70 (76%); the rest is the patient’s coinsurance and deductible.

Services: 21,774
Beneficiaries: 16,289
Providers billing it: 533
Total allowed: $3,328,809

What Medicare pays for CPT 95250

Across 21,774 services billed by 533 providers to 16,289 beneficiaries, Medicare allowed an average of $152.88 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95250

Specialty	Services	Beneficiaries	Avg allowed	Providers
Endocrinology	14,433	11,038	$153.87	321
Internal Medicine	3,359	2,336	$149.68	84
Nurse Practitioner	2,622	1,844	$151.19	72
Family Practice	595	503	$150.82	29
Physician Assistant	448	362	$147.33	17
General Practice	128	57	$158.32	4
Nephrology	62	53	$172.45	2
Preventive Medicine	60	40	$187.61	1
Hospitalist	27	22	$188.10	1
Cardiology	25	19	$152.37	1
Interventional Cardiology	15	15	$132.53	1

95250 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	3,896	$173.21	$108.94	67
New Jersey	3,157	$166.87	$111.74	50
Florida	2,172	$143.30	$105.77	47
California	2,085	$174.24	$110.34	55
Texas	1,940	$139.72	$107.44	58
Illinois	804	$145.37	$108.78	31
Mississippi	770	$135.30	$112.48	2
Georgia	717	$132.01	$106.83	17
South Carolina	624	$133.94	$103.54	22
Michigan	538	$141.24	$110.68	16
Maryland	446	$154.67	$106.70	16
North Carolina	436	$135.42	$109.69	12
Indiana	385	$133.12	$104.43	10
Arizona	342	$139.96	$110.30	10
Massachusetts	341	$153.33	$104.86	15
Pennsylvania	287	$139.67	$107.98	13
Tennessee	274	$127.86	$99.50	11
Virginia	263	$144.54	$105.44	8
Nevada	217	$135.36	$109.73	6
Alabama	206	$121.30	$106.28	7
New Hampshire	176	$141.91	$95.36	3
Oregon	163	$141.57	$100.26	1
Minnesota	148	$142.09	$98.06	5
Ohio	138	$132.90	$104.83	5
Colorado	121	$150.88	$103.16	3
Oklahoma	116	$126.44	$105.41	4
Missouri	109	$136.51	$103.04	4
New Mexico	109	$130.87	$93.09	2
Kentucky	102	$120.71	$88.62	4
Iowa	88	$131.00	$112.76	3
Connecticut	83	$160.78	$106.00	4
West Virginia	81	$137.17	$107.89	2
Washington	76	$148.94	$97.09	3
Delaware	75	$146.34	$108.64	2
Louisiana	64	$122.41	$107.48	4
Kansas	45	$130.77	$92.10	1
U.S. Virgin Islands	37	$145.93	$100.39	1
Arkansas	30	$124.17	$107.25	1
Montana	28	$145.76	$79.79	2
Wisconsin	23	$140.20	$102.91	2
Nebraska	19	$137.55	$112.39	1
Puerto Rico	16	$145.37	$98.69	1
Alaska	15	$156.05	$98.16	1
Rhode Island	12	$160.28	$89.95	1

Related codes

95251Continuous monitoring of blood sugar level in tissue fluid$32.37
95249Continuous monitoring of blood sugar level in tissue fluid$66.48

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.