CPT 59025: Fetal Nonstress Test, Heart Rate Response to Movement
Medicare pays $34 and commercial payers pay $159 on average nationally for this procedure.
CPT code 59025 describes a fetal nonstress test in which the provider measures the fetus’s heart rate response to its own movements; this is an obstetrical fetal heart rate monitoring service typically performed as a nonstress test in an outpatient clinic or hospital outpatient setting to assess fetal well‑being during pregnancy.
For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.
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National Reimbursement Benchmarks
Medicare’s national mean of $34.4 sits well below BUCA’s average commercial mean of $159.1 for CPT 59025, illustrating a substantial gap between federal payment levels and that commercial benchmark. The separation suggests Medicare reimbursement is roughly $124.7 lower than BUCA’s mean, placing Medicare toward the lower end of the overall national spectrum while BUCA aligns with higher commercial payment tiers.
Dispersion measured by the interquartile spread (P75 minus P25) varies notably across payers. Blue Cross Blue Shield shows one of the widest IQRs at $61.1, indicating greater variability among commercial contracts, while Cigna’s IQR is $39.9 and UnitedHealth Group’s is $35.9. Aetna’s IQR of $55.9 is also relatively wide. BUCA’s IQR is $53.6, and Medicare’s IQR is $26, the tightest of the group, reflecting more consistent locality-based Medicare payments.