$150.85
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.
On this page
CMS RVU26D · Effective 2026-10-01
95801 Sleep study Medicare reimbursement rates in Connecticut
Reports an unattended sleep study recording heart rate, oxygen saturation, and respiratory signals to evaluate suspected sleep-disordered breathing. Compare 95801 office and facility rates across CMS payment localities in Connecticut.
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 95801 in Connecticut?
Connecticut 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
$110.56
1 of 1 localities have a supported rate.
Payment area: Connecticut
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.
Sleep testing
About 95801: Unattended sleep study without sleep-time recording
Reports an unattended sleep study recording heart rate, oxygen saturation, and respiratory signals to evaluate suspected sleep-disordered breathing.
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.
CMS billing rules for 95801
- 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.
Where the value comes from
- Work RVU0.83 · 27%
- Practice expense (office) RVU2.22 · 71%
- Malpractice RVU0.06 · 2%
328
Medicare services in 2024 · #3928 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.
95801 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$109.69
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.
$476.09
Code 95807 describes an attended sleep study. Code 95801 is for unattended recording without an attending technologist.
Compare 95801 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
Connecticut →
Office / nonfacility
$110.56
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 95801 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
12,526
- Code
- 95801
- Physician work
- 0.83
- Practice expense
- 2.22
- Malpractice
- 0.06
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.020 | 0.8466 |
| Practice expense | 2.22 | × 1.077 | 2.3909 |
| Malpractice | 0.06 | × 1.210 | 0.0726 |
| Total RVUs | 3.3101 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$110.56
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1.02 |
| Practice expense | 2.22 | 1.077 |
| Malpractice | 0.06 | 1.21 |
(0.83 × 1.02 + 2.22 × 1.077 + 0.06 × 1.21) × $33.4009 = $110.56
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.
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 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.
12,52395800,,Slp stdy unattended,A,,0.83,3.34,,3.34,NA,0.06,4.23,4.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52495800,26,Slp stdy unattended,A,,0.83,0.29,,0.29,,0.04,1.16,1.16,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52595800,TC,Slp stdy unattended,A,,0.00,3.05,,3.05,NA,0.02,3.07,3.07,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52695801,,Slp stdy unatnd w/anal,A,,0.83,2.22,,2.22,NA,0.06,3.11,3.11,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52795801,26,Slp stdy unatnd w/anal,A,,0.83,0.36,,0.36,,0.04,1.23,1.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52895801,TC,Slp stdy unatnd w/anal,A,,0.00,1.86,,1.86,NA,0.02,1.88,1.88,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52995803,,Actigraphy testing,A,,0.88,3.12,,3.12,NA,0.05,4.05,4.05,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808