What CPT 95938 represents in IDR
Short-latency somatosensory evoked potential study, stimulation of any/all peripheral nerves or skin sites, recording from the central nervous system; in upper and lower limbs.
For IDR strategy, the code-level view matters because payer behavior can look different after the QPA, state, and service category are held constant. Use this page to compare your CPT 95938 disputes against the CMS benchmark before escalating volume.
CPT 95938 outcomes by state
| State | Disputes | Provider win rate | Median award | Median award dollars |
|---|---|---|---|---|
| Texas | 10,030 | 87.4% | 109x | $4,800 |
| Florida | 5,560 | 86.2% | 33.0x | $1,817 |
| New Jersey | 4,145 | 82.8% | 103x | $7,227 |
| Ohio | 2,870 | 82% | 138x | $8,746 |
| Georgia | 2,692 | 84% | 56.1x | $4,300 |
| New York | 2,651 | 83.3% | 104x | $8,342 |
| Pennsylvania | 2,447 | 84% | 34.1x | $6,672 |
| Colorado | 2,349 | 82.4% | 49.5x | $3,951 |
Top payers for CPT 95938
| Payer | Disputes | Provider win rate | Median award |
|---|---|---|---|
| BCBSTX | 11,693 | 91.6% | 63.1x |
| UnitedHealthcare | 10,801 | 78.6% | 36.1x |
| Anthem Blue Cross | 7,011 | 86.1% | 92.5x |
| Cigna / MultiPlan | 4,148 | 78.8% | 87.4x |
| Florida Blue | 3,622 | 92.3% | 37.5x |
| Aetna | 3,360 | 89% | 37.9x |
| UMR | 3,202 | 82% | 34.2x |
| Highmark Blue Shield | 806 | 81.9% | 37.3x |
Recent CPT 95938 quarterly trend
| Quarter | Disputes | Provider win rate | Median award |
|---|---|---|---|
| 2025Q1 | 12,831 | 82.3% | 38.4x |
| 2025Q2 | 15,264 | 86.2% | 52.7x |
| 2025Q3 | 13,627 | 87.5% | 46.5x |
| 2025Q4 | 13,345 | 81.9% | 59.0x |
Open CPT 95938 in the explorer
Filter CPT 95938 by state, year, and payer to compare the public benchmark with your own out-of-network payment experience.
FAQ
How many CPT 95938 IDR disputes are in the dataset?
This benchmark shows 55,067 CPT 95938 disputes.
What is the CPT 95938 median award multiple?
The median provider-won award is 49.3x QPA.
Why compare CPT 95938 by state and payer?
State and payer mix can change both QPA and outcomes, so a code-level national average should be narrowed before deciding how to route disputes.
Related benchmarks
Sources and method
- CMS: Federal IDR reports and public use files
- CMS: About Independent Dispute Resolution
- CMS: Federal IDR timeline for claims
Data source: CMS Federal IDR public use files, coverage through 2025Q4; data build 2026-09-21. Counts are CMS dispute counts unless a table says line items. Win rates labeled non-default exclude payer no-show defaults. Award multiples are medians versus QPA. Dollar figures, where shown, are anchored estimates from CMS QPA-and-offer fields, not payment records. This page is informational, not legal or reimbursement advice.