CPT code 95806: Sleep study, heart rate and respiratory signals2026 Medicare rate & RVUs in New Jersey
Report this unattended sleep study when a portable test simultaneously records heart rate, oxygen saturation, airflow, and respiratory effort to assess sleep-disordered breathing.
Medicare pays $111.13–$116.59 for 95806 in the office in New Jersey, from Rest of New Jersey to Northern New Jersey. 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 95806 covers
This unattended test records heart rate, oxygen saturation, respiratory airflow, and respiratory effort at the same time. It is commonly performed with a portable monitor in a patient’s home to evaluate suspected sleep-disordered breathing, including obstructive sleep apnea. Clinical staff may prepare the equipment and instruct the patient, while a qualified practitioner interprets the recorded data. The patient is not continuously attended by a technologist during the recording.
Select this code when the study includes the specified combination of signals; document the test performed and retain the recording and interpretation. It differs from unattended studies with other signal sets and from attended laboratory studies. The global service is billed without a component modifier. Modifier 26 identifies the professional interpretation, while modifier TC identifies the equipment and staff component; CMS separately prices both modifiers.
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 95806 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | $116.59 | Unavailable |
| Rest of New Jersey | $111.13 | Unavailable |
How the 95806 rate is calculated
Each of 95806’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 · 95806
RVUs × geographic indexes × conversion factor
Work0.91
0.91 RVUs× 1.000 GPCI
Practice expense2.12
2.12 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
3.0900
Conversion factor
$33.4009
Medicare rate
$103.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95806
The CMS indicators that decide how 95806 is paid alongside other services.
CMS payment indicators · 95806
Sleep study, heart rate and respiratory signals
| 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
95806 without 26 · national office
$103.21
Sleep study, heart rate and respiratory signals
95806-26 · Professional component
$44.76
Pays only the interpretation and report.
95806 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95800Home sleep studyUnattended, includes sleep time
- Both are unattended sleep studies, but 95800 includes sleep-time measurement. This code is identified by simultaneous heart-rate, oxygen-saturation, airflow, and respiratory-effort recording.
- 95801Sleep studyUnattended, limited channels
- Code 95801 allows a minimum of three channels with respiratory-analysis signal choices. Choose this code when the recorded study includes its specified four-signal combination.
- 95807Sleep studyTechnologist-attended recording
- Code 95807 is an attended sleep study. This code describes an unattended recording, commonly collected with a portable monitor.
- 95810Sleep studyAge six or older, attended
- Code 95810 is attended laboratory polysomnography for patients age six or older, with four or more parameters. This code is for the specified unattended cardiorespiratory recording.
95806 billing questions
How does this differ from 95800?
This code is for simultaneous recording of heart rate, oxygen saturation, airflow, and respiratory effort. Code 95800 is an unattended study that includes sleep-time measurement.
How does this differ from 95801?
Code 95801 covers an unattended study with a minimum of three channels and a broader choice of respiratory-analysis signals. Use this code when the study records the specific heart-rate, oxygen-saturation, airflow, and respiratory-effort combination.
When should modifier 26 or TC be reported?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Bill without either modifier when reporting the global service.
Is this the code for an attended sleep-laboratory study?
No. This code describes an unattended recording. An attended study, such as 95807 or 95810, is selected when the patient is monitored in a sleep laboratory.
What documentation supports reporting this code?
Document that the study was unattended and that the recording included heart rate, oxygen saturation, airflow, and respiratory effort. Keep the test data and the interpreting practitioner’s report.
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.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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