CPT code 95819: EEG, awake and asleep recording2026 Medicare rate & RVUs in Massachusetts
Reports a scalp EEG that records both wakefulness and sleep when evaluating suspected seizures, episodic altered awareness, or other cerebral dysfunction.
Medicare pays $505.63–$569.39 for 95819 in the office in Massachusetts, from Rest of Massachusetts to Metropolitan Boston, MA. 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 95819 covers
A technologist places scalp electrodes and records brain electrical activity during wakefulness and sleep. A physician, commonly a neurologist, interprets the tracing. The study may be performed in an outpatient diagnostic department, clinic, or hospital when a clinician needs to assess events such as suspected seizures or episodes of altered awareness and wants both states represented in the recording.
Choose this code when the EEG includes awake and sleep recording, rather than selecting solely by the patient’s presenting symptom. The report should identify the states captured and include the interpretation; the technical record supports the equipment and staff portion. CMS recognizes separately priced professional and technical components: report modifier 26 for the interpretation and modifier TC for the equipment and staff. Without either modifier, the claim represents 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 95819 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston, MA | $569.39 | Unavailable |
| Rest of Massachusetts | $505.63 | Unavailable |
How the 95819 rate is calculated
Each of 95819’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 · 95819
RVUs × geographic indexes × conversion factor
Work1.05
1.05 RVUs× 1.000 GPCI
Practice expense13.28
13.28 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
14.4400
Conversion factor
$33.4009
Medicare rate
$482.31
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95819
The CMS indicators that decide how 95819 is paid alongside other services.
CMS payment indicators · 95819
EEG, awake and asleep recording
| 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
95819 without 26 · national office
$482.31
EEG, awake and asleep recording
95819-26 · Professional component
$56.78
Pays only the interpretation and report.
95819 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 95816EEGAwake and drowsy
- Use 95816 for awake-and-drowsy recording. Use 95819 when the EEG includes sleep recording as well as wakefulness.
- 95822EEGSleep or coma only
- 95822 describes an EEG recorded only during sleep or coma; 95819 includes both awake and sleep states.
- 95812EEG monitoring41–60 minutes
- 95812 is associated with a specified recording-duration range. 95819 is distinguished by recording both awake and sleep states.
- 95813EEG recording61–119 minutes
- 95813 is associated with a longer specified recording-duration range. Select 95819 when the documented service is an awake-and-sleep EEG rather than by duration.
95819 billing questions
How does this differ from 95816?
95819 represents an EEG with awake and sleep recording. 95816 is the closer choice when the recording is awake and drowsy rather than asleep.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion. Without a modifier, the service is billed globally.
What documentation supports reporting 95819?
The EEG record and report should support that both awake and sleep states were recorded, with the physician’s interpretation documented.
Is code selection based on recording time?
This code distinguishes the awake-and-sleep recording pattern. Codes 95812 and 95813 are associated with specified recording-duration ranges, so review the actual service and documentation when choosing between them.
When is 95822 a better fit?
95822 is for an EEG recorded only during sleep or coma. Use 95819 when the study includes both awake and sleep recording.
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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