Billing code 95726: Video EEG reviewMedicare rate & RVUs in Illinois
Physician or qualified health care professional review and interpretation of video EEG monitoring lasting more than 84 hours, with a documented report.
Medicare pays $424.47–$455.02 for 95726 in the office in Illinois, from Rest Of Illinois to Chicago. 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 9 sections
What 95726 covers
This service captures the physician or qualified health care professional’s review and interpretation of a prolonged EEG recording accompanied by synchronized video. It is used in extended seizure evaluations, such as monitoring in an epilepsy unit to assess suspected seizures and correlate recorded behaviors with electrical activity. The service includes interpretation and a report, rather than the equipment setup or technical monitoring work.
Choose 95726 when the video EEG monitoring duration exceeds 84 hours. The duration and presence of video distinguish it from shorter-duration codes and from 95725, which describes the corresponding service without video. Documentation should support the monitoring duration, video availability, the clinical question, the findings interpreted, and the resulting report. Report any separately coded recording or technical services based on the work performed and the applicable service codes.
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 95726 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$424.47 to $455.02
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $455.02 | $373.79 |
| East St. Louis | $434.59 | $360.22 |
| Rest Of Illinois | $424.47 | $350.68 |
| Suburban Chicago | $447.91 | $364.90 |
How the 95726 rate is calculated
Each of 95726’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 · 95726
RVUs × geographic indexes × conversion factor
Work7.58
7.58 RVUs× 1.000 GPCI
Practice expense4.59
4.59 RVUs× 1.000 GPCI
Malpractice0.60
0.60 RVUs× 1.000 GPCI
Adjusted RVUs
12.7700
Conversion factor
$33.4009
Medicare rate
$426.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 95726
95726 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 95726
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
$426.53
- Non-facility (office)
- $426.53
- Facility
- $345.70
Higher because the practice carries its own overhead.
95726 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 95725EEG interpretation
- Use 95725 for interpretation of monitoring over 84 hours without video; 95726 includes video.
- 95724Video EEG interpretation
- Use 95724 when video EEG monitoring lasts more than 60 hours through 84 hours. 95726 is for monitoring over 84 hours.
- 95716Veeg ea 12-26hr cont mntr
- 95716 describes technical continuous video EEG monitoring in its duration category; 95726 describes physician or QHP review, interpretation, and reporting for monitoring over 84 hours.
95726 billing questions
How is 95726 different from 95725?
95726 is for physician or qualified health care professional interpretation of monitoring over 84 hours with video. 95725 covers the corresponding duration without video.
When should a shorter-duration video EEG code be selected?
Select the code that matches the total monitoring duration. For example, 95724 is the video EEG interpretation code for monitoring lasting more than 60 hours through 84 hours.
Does 95726 include equipment setup or technical monitoring?
The code represents physician or qualified health care professional review, interpretation, and reporting. Setup and technical monitoring are distinct services when performed and reported.
What documentation supports reporting 95726?
Document that video accompanied the EEG, the monitoring duration exceeded 84 hours, and the physician or qualified health care professional reviewed and interpreted the recording and produced a report.
Is video indicated by a modifier?
No. Video is part of the code selection: use 95726 for the over-84-hour service with video and 95725 for the corresponding service without video.
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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