$134.28
95925 covers upper-limb somatosensory testing; 95938 is used when both upper and lower limbs are tested.
On this page
CMS RVU26D · Effective 2026-10-01
95938 Sensory evoked potentials Medicare reimbursement rates in Alabama
Reports somatosensory evoked-potential testing of upper and lower limb pathways, often used to assess sensory conduction or monitor neural function during surgery. Compare 95938 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 95938 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$352.70
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Neurophysiology testing
About 95938: Upper and lower limb sensory evoked potentials
Reports somatosensory evoked-potential testing of upper and lower limb pathways, often used to assess sensory conduction or monitor neural function during surgery.
This study evaluates sensory pathways by stimulating peripheral nerves in the upper and lower limbs and recording evoked responses along the pathway, including at peripheral, spinal, and cortical sites. Neurologists or other qualified clinicians interpret the responses; trained technical staff may perform the stimulation and recording. The study may be performed in a diagnostic neurophysiology laboratory or during surgery when sensory pathway monitoring is needed.
Select this code when the testing covers both upper and lower limbs, rather than only one limb group or dermatomal stimulation. The report should identify the nerves or sites tested, the recorded responses, and the interpretation. Medicare recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier for the global service. The code is priced as bilateral, so modifier 50 does not increase payment.
CMS billing rules for 95938
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Bilateral procedures
- The code is already priced as bilateral; modifier 50 does not increase payment.
Where the value comes from
- Work RVU0.84 · 7%
- Practice expense (office) RVU11.05 · 92%
- Malpractice RVU0.09 · 1%
102.8K
Medicare services in 2024 · #548 by national volume
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.
95938 compared with similar codes
Office rates for Alabama, from the same CMS release.
$120.65
95926 covers lower-limb somatosensory testing; 95938 is used when testing includes both upper and lower limbs.
$150.35
95927 uses dermatomal stimulation. Choose 95938 for testing upper- and lower-limb sensory pathways through peripheral nerve stimulation.
$523.14
95939 evaluates motor evoked potentials in upper and lower limbs. 95938 evaluates somatosensory pathways.
Compare 95938 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$352.70
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 95938 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
12,690
- Code
- 95938
- Physician work
- 0.84
- Practice expense
- 11.05
- Malpractice
- 0.09
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.84 | × 1.000 | 0.8400 |
| Practice expense | 11.05 | × 0.875 | 9.6688 |
| Malpractice | 0.09 | × 0.566 | 0.0509 |
| Total RVUs | 10.5597 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$352.70
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.84 | 1 |
| Practice expense | 11.05 | 0.875 |
| Malpractice | 0.09 | 0.566 |
(0.84 × 1 + 11.05 × 0.875 + 0.09 × 0.566) × $33.4009 = $352.70
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
95938 billing questions
When should 95938 be chosen over 95925 or 95926?
Use 95938 for somatosensory evoked-potential testing that covers both upper and lower limbs. Codes 95925 and 95926 describe testing of upper limbs and lower limbs, respectively.
Does 95938 include bilateral testing?
Yes. CMS prices the code as bilateral; modifier 50 does not increase payment.
Which component modifier should be reported?
Report modifier 26 for the professional interpretation or modifier TC for the technical service. Report the global service without either modifier.
Is 95938 a sensory or motor evoked-potential study?
It is a somatosensory study of sensory pathways. Motor evoked-potential testing is distinct; 95939 covers upper- and lower-limb motor evoked potentials.
What documentation supports reporting 95938?
Document the upper- and lower-limb nerves or sites stimulated, the responses recorded, and the clinician's interpretation of the findings.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,68795937,,Neuromuscular junction test,A,,0.63,2.52,,2.52,NA,0.04,3.19,3.19,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,68895937,26,Neuromuscular junction test,A,,0.63,0.36,,0.36,,0.03,1.02,1.02,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,68995937,TC,Neuromuscular junction test,A,,0.00,2.16,,2.16,NA,0.01,2.17,2.17,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,7A,0,99,0.00,0.00,0.00
12,69095938,,Somatosensory testing,A,,0.84,11.05,,11.05,NA,0.09,11.98,11.98,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,69195938,26,Somatosensory testing,A,,0.84,0.47,,0.47,,0.04,1.35,1.35,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,69295938,TC,Somatosensory testing,A,,0.00,10.58,,10.58,NA,0.05,10.63,10.63,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,21,0,99,0.00,0.00,0.00
12,69395939,,C motor evoked upr&lwr limbs,A,,2.19,15.30,,15.30,NA,0.15,17.64,17.64,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515