Billing code 95805: Sleep latency testMedicare rate & RVUs

Reports daytime nap testing that measures sleep propensity, commonly used to evaluate persistent excessive sleepiness and suspected narcolepsy after overnight sleep assessment.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.8K Medicare services in 2024

Medicare pays $479.64 for 95805 nationally in the office. Local office rates run $415.56–$673.52.

Medicare rate · 95805

Sleep latency test

Swap in your local Medicare rate.

Work RVUs
1.17
Total RVUs
14.36
Global days
XXX

National rate · 2026

$479.64

Office setting, before claim adjustments.

See every locality for 95805 → · Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

On this page 10 sections
  1. Medicare rate
  2. What 95805 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 95805 covers

A multiple sleep latency test uses repeated, scheduled daytime nap opportunities to assess how readily a patient falls asleep and whether sleep-onset features support a central hypersomnolence disorder such as narcolepsy. A sleep technologist typically conducts the recording in a sleep laboratory, and a qualified interpreting professional reviews the results and prepares the report. The test commonly follows an overnight attended polysomnography as part of an evaluation for persistent excessive daytime sleepiness.

Report 95805 for the daytime test, not for the preceding overnight study or for each nap opportunity separately. The record should support the clinical reason for testing and include the test findings and interpretation. CMS recognizes a professional component, reported with modifier 26, and a technical component, reported with modifier TC; reporting the code without a modifier represents the global service, including both components. CMS separately prices the 26 and TC services.

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 95805 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$415.56 to $673.52

$415.56$544.54$673.52
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

95805 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$422.81Unavailable
Alaska*$524.89Unavailable
Arizona$465.34Unavailable
Arkansas$415.56Unavailable
Atlanta$487.85Unavailable
Austin$504.29Unavailable
Bakersfield$519.91Unavailable
Baltimore/Surr. Cntys$513.35Unavailable
Beaumont$440.09Unavailable
Brazoria$474.79Unavailable

95805 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$415.56

$596.47

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
95805 office rate range by state
State / territoryOffice rate rangeLocalities
AK$524.891
AL$422.811
AR$415.561
AZ$465.341
CA$519.42–$673.5229
CO$506.691
CT$515.101
DC$559.801
DE$474.041
FL$463.36–$506.153
GA$433.76–$487.852
GU$536.821
HI$536.821
IA$439.251
ID$441.851
IL$445.00–$496.044
IN$444.971
KS$435.071
KY$430.881
LA$429.39–$454.752
MA$502.16–$564.982
MD$484.78–$559.803
ME$442.70–$473.632
MI$442.53–$468.312
MN$488.251
MO$419.48–$458.773
MS$417.711
MT$479.631
NC$448.451
ND$476.261
NE$442.621
NH$496.761
NJ$521.76–$552.072
NM$444.681
NV$479.121
NY$456.21–$569.205
OH$441.851
OK$431.841
OR$476.21–$527.082
PA$443.66–$499.272
PR$484.341
RI$494.121
SC$445.731
SD$475.871
TN$437.431
TX$440.09–$504.298
UT$452.961
VA$470.57–$559.802
VI$484.341
VT$472.481
WA$501.84–$579.272
WI$457.441
WV$425.111
WY$478.161

How the 95805 rate is calculated

Each of 95805’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 · 95805

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 1.17Practice expense 13.02Malpractice 0.17

14.3600 adjusted RVUs×$33.4009 conversion factor=$479.64

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 95805

The CMS indicators that decide how 95805 is paid alongside other services.

CMS payment indicators · 95805

Sleep latency test

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

95805 without 26 · national office

$479.64

Sleep latency test

95805-26 · Professional component

$57.78

Pays only the interpretation and report.

When to use modifier 26

95805 compared with similar codes

Compare codes

95805 vs 95810 vs 95811 vs 95803: national Medicare rates

Swap in your local Medicare rate.

  • 95805
    Sleep latency test · 1.17 wRVU
    $479.64
  • 95810
    Sleep study · 2.44 wRVU
    $673.70+$194.06
  • 95811
    Sleep study · 2.54 wRVU
    $707.77+$228.13
  • 95803
    Actigraphy testing · 0.88 wRVU
    $135.27−$344.37

How to choose

95810Sleep study
95810 is an attended overnight polysomnography. 95805 is daytime nap testing, often performed after the overnight study.
95811Sleep study
95811 is an attended polysomnography with positive airway pressure titration; 95805 measures daytime sleep propensity rather than titrating breathing treatment.
95803Actigraphy testing
95803 is actigraphy testing. It records sleep-wake patterns over time, whereas 95805 uses scheduled daytime nap opportunities to assess sleep propensity.

95805 billing questions

When is 95805 appropriate instead of an overnight sleep study?

Use 95805 for daytime nap testing of sleep propensity, often when evaluating persistent excessive sleepiness or suspected narcolepsy. An overnight polysomnography evaluates sleep during the night and may precede the MSLT.

Can the preceding polysomnography also be reported?

The overnight study and the daytime MSLT are distinct services. When both are performed, report the appropriate code for each documented test.

How are the professional and technical components reported?

Report modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, 95805 represents the global service.

Should a unit be reported for each nap opportunity?

No. Report the MSLT as the test service rather than billing each scheduled nap opportunity as a separate unit.

What documentation supports 95805?

Document the clinical indication for daytime sleepiness testing, the nap-test findings, and the interpreting professional's report. The record should distinguish the daytime MSLT from any overnight sleep study.

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

Show the CMS file lines behind this rate
RVUs for 95805PPRRVU2026_Oct_nonQPP.csv, line 12,532 (RVU26D)

Open CMS sourceHow we calculate rates

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