$95.76
Both describe unattended sleep studies with heart rate, oxygen saturation, and respiratory analysis. 95800 includes sleep-time measurement; 95801 does not.
On this page
CMS RVU26D · Effective 2026-10-01
95800 Home sleep study Medicare reimbursement rates in Kansas
Reports an unattended sleep study that records heart rate, oxygen saturation, respiratory data, and sleep time, commonly for evaluation of suspected sleep apnea. Compare 95800 office and facility rates across CMS payment localities in Kansas.
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 95800 in Kansas?
Kansas 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
$129.58
1 of 1 localities have a supported rate.
Payment area: Kansas
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 medicine
About 95800: Unattended sleep study with sleep time
Reports an unattended sleep study that records heart rate, oxygen saturation, respiratory data, and sleep time, commonly for evaluation of suspected sleep apnea.
This code describes an unattended sleep study using portable equipment to record heart rate, oxygen saturation, respiratory information, and sleep time during a sleep period. It is commonly used when evaluating a patient for suspected obstructive sleep apnea outside a sleep laboratory. A sleep medicine physician or other qualified interpreting professional reviews the recorded data and prepares the interpretation; equipment and staff support the technical portion of the test.
Select this code when the study includes sleep-time measurement along with the specified physiologic data. The report should identify the study performed and document the recorded data and the interpreting professional’s findings. CMS recognizes professional and technical components: report modifier 26 for interpretation or modifier TC for equipment and staff; without a component modifier, the claim represents the global service. CMS separately prices these modifier components.
CMS billing rules for 95800
- 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 · 20%
- Practice expense (office) RVU3.34 · 79%
- Malpractice RVU0.06 · 1%
176.7K
Medicare services in 2024 · #406 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.
95800 compared with similar codes
Office rates for Kansas, from the same CMS release.
$95.42
95806 identifies an unattended study that records respiratory effort and airflow. 95800 includes sleep-time measurement and has its own specified data configuration.
$402.72
95800 is unattended, typically using portable equipment. 95807 describes an attended sleep study.
$613.37
95810 is attended in-laboratory polysomnography with multiple monitored parameters; 95800 is an unattended study with a more limited specified recording.
Compare 95800 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
Kansas →
Office / nonfacility
$129.58
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 95800 in Kansas.
PPRRVU2026_Oct_nonQPP.csv
12,523
- Code
- 95800
- Physician work
- 0.83
- Practice expense
- 3.34
- Malpractice
- 0.06
GPCI2026.csv
54
- Locality
- Kansas
- Physician work
- 1.000
- Practice expense
- 0.904
- Malpractice
- 0.504
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 3.34 | × 0.904 | 3.0194 |
| Malpractice | 0.06 | × 0.504 | 0.0302 |
| Total RVUs | 3.8796 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kansas$129.58
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1 |
| Practice expense | 3.34 | 0.904 |
| Malpractice | 0.06 | 0.504 |
(0.83 × 1 + 3.34 × 0.904 + 0.06 × 0.504) × $33.4009 = $129.58
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.
95800 billing questions
How does 95800 differ from 95801?
95800 includes sleep-time measurement in addition to heart rate, oxygen saturation, and respiratory analysis. Choose 95801 when the study does not include sleep-time measurement.
How does 95800 differ from 95806?
The codes describe different unattended study data configurations. 95800 includes sleep time, while 95806 identifies a study with respiratory effort and airflow.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the equipment and staff portion. Billing without either modifier represents the global service.
What documentation supports reporting 95800?
Document the unattended study performed, the data recorded—including sleep time—and the interpreting professional’s findings.
Is 95800 an attended laboratory study?
No. It describes an unattended study. Code 95807 describes an attended 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 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.
12,52095783,,Polysom <6 yrs cpap/bilvl,A,,2.76,28.90,,28.90,NA,0.35,32.01,32.01,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52195783,26,Polysom <6 yrs cpap/bilvl,A,,2.76,1.10,,1.10,,0.07,3.93,3.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52295783,TC,Polysom <6 yrs cpap/bilvl,A,,0.00,27.80,,27.80,NA,0.28,28.08,28.08,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52395800,,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
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958