Billing code 95803: Actigraphy testingMedicare rate & RVUs in Florida
Reports actigraphy recording and analysis over at least 72 hours to assess sleep-wake patterns, such as in insomnia or circadian rhythm evaluation.
Medicare pays $131.53–$142.10 for 95803 in the office in Florida, from Rest Of Florida to Miami. 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.
On this page 8 sections
What 95803 covers
Actigraphy uses a wearable motion-sensing device, commonly worn on the wrist, to record activity and rest over time and estimate sleep-wake patterns. A sleep medicine clinician may use the results when evaluating insomnia, a suspected circadian rhythm sleep-wake disorder, or a mismatch between reported sleep and observed routines. The test covers recording for at least 72 hours, followed by analysis, interpretation, and a report; it does not measure sleep stages or respiratory events like a sleep study.
Report 95803 for the actigraphy service, supported by documentation of the recording period, analysis, interpretation, and findings. The code has separately priced professional and technical components: modifier 26 identifies interpretation, while modifier TC identifies equipment and staff. Reporting the code without either modifier represents the global service. The record should identify the device-based recording period and explain how the results address the sleep-wake question being evaluated.
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 95803 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$131.53 to $142.10
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $137.98 | Unavailable |
| Miami | $142.10 | Unavailable |
| Rest Of Florida | $131.53 | Unavailable |
How the 95803 rate is calculated
Each of 95803’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 · 95803
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.88Practice expense 3.12Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95803
The CMS indicators that decide how 95803 is paid alongside other services.
CMS payment indicators · 95803
Actigraphy testing
| 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
95803 without 26 · national office
$135.27
Actigraphy testing
95803-26 · Professional component
$42.75
Pays only the interpretation and report.
95803 compared with similar codes
Compare codes
95803 vs 95800 vs 95805 vs 95806 vs 95810: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95800Home sleep study
- 95800 is an unattended sleep study that includes sleep-related physiologic measurements. Choose 95803 for extended movement-based sleep-wake pattern assessment, not respiratory testing.
- 95805Sleep latency test
- 95805 measures physiologic sleep propensity with a multiple sleep latency test. Actigraphy instead records movement-based sleep-wake patterns over an extended period.
- 95806Sleep study
- 95806 is an unattended sleep study with respiratory effort monitoring. It evaluates a different question from actigraphy’s assessment of sleep-wake patterns.
- 95810Sleep study
- 95810 is an attended polysomnography service with multiple physiologic channels. Use 95803 for movement-based sleep-wake pattern assessment rather than overnight sleep-stage and physiologic monitoring.
95803 billing questions
How is actigraphy different from an unattended sleep study?
Actigraphy tracks movement over time to estimate sleep and wake patterns. An unattended sleep study, such as 95800 or 95806, records physiologic data used to evaluate sleep-related breathing or other sleep-study questions.
Can 95803 be reported with modifier 26 or TC?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the code represents the global service.
What recording duration supports this code?
The test involves at least 72 hours of actigraphy recording, followed by analysis, interpretation, and a report. Document the actual recording period and resulting findings.
Does actigraphy measure sleep stages or breathing?
No. It estimates sleep and wake from recorded movement; it does not provide sleep-stage or respiratory-event measurements like polysomnography or a sleep apnea test.
What documentation should accompany the claim?
Document the clinical sleep-wake question, recording period, analysis and interpretation, and findings. For a component claim, identify whether the service was professional interpretation or technical equipment and staff.
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
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