CPT code 95801: Sleep study, unattended, limited channels2026 Medicare rate & RVUs in Maine
Reports an unattended sleep study recording heart rate, oxygen saturation, and respiratory signals to evaluate suspected sleep-disordered breathing.
Medicare pays $97.19–$102.47 for 95801 in the office in Maine, from Rest of Maine to Southern Maine, ME. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 95801 covers
This service is an unattended recording of heart rate, oxygen saturation, and respiratory activity, such as airflow or peripheral arterial tone. It is commonly used as a home sleep apnea test when a clinician evaluates suspected obstructive sleep apnea and selects a limited-channel study. The patient wears the recording equipment without a technologist attending the study; a qualified professional reviews and interprets the recorded data.
Select this code for the recorded signals, not simply because testing occurred at home. Distinguish it from related sleep-study codes by the measurements actually captured: this code does not include sleep-time recording or respiratory-effort recording. Documentation should identify the study performed, recorded signals, test data, and interpretation. CMS recognizes separately priced professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier for the global service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 95801 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest of Maine | $97.19 | Unavailable |
| Southern Maine, ME | $102.47 | Unavailable |
How the 95801 rate is calculated
Each of 95801’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 95801
RVUs × geographic indexes × conversion factor
Work0.83
0.83 RVUs× 1.000 GPCI
Practice expense2.22
2.22 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
3.1100
Conversion factor
$33.4009
Medicare rate
$103.88
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95801
The CMS indicators that decide how 95801 is paid alongside other services.
CMS payment indicators · 95801
Sleep study, unattended, limited channels
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
95801 without 26 · national office
$103.88
Sleep study, unattended, limited channels
95801-26 · Professional component
$41.08
Pays only the interpretation and report.
95801 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95800Home sleep studyUnattended, includes sleep time
- Use 95800 when the unattended recording includes sleep-time measurement. Code 95801 covers the limited set of heart-rate, oxygen-saturation, and respiratory signals without that measurement.
- 95806Sleep studyHeart rate and respiratory signals
- Code 95806 includes respiratory-effort recording along with other sleep-study signals. Code 95801 is appropriate when respiratory effort is not among the recorded parameters.
- 95807Sleep studyTechnologist-attended recording
- Code 95807 describes an attended sleep study. Code 95801 is for unattended recording without an attending technologist.
95801 billing questions
How does this differ from 95800?
Code 95800 includes sleep-time recording in addition to the signals reported with 95801. Choose based on the measurements captured by the study.
When is 95806 a better fit?
Code 95806 includes respiratory-effort recording. Use 95801 when the documented unattended study records heart rate, oxygen saturation, and respiratory analysis without that additional signal.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or modifier TC for the technical equipment-and-staff portion. Without either modifier, the code represents the global service.
What supports reporting the professional component?
The record should support review and interpretation of the study data, including a documented interpretation by the responsible qualified professional.
Is this an attended laboratory polysomnography code?
No. This code describes unattended recording. An attended sleep study, such as 95807 or polysomnography such as 95810, represents a different testing setup.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
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