Billing code 95954: EEG activationMedicare rate & RVUs in Oregon
Reports medication used to provoke diagnostic EEG changes during evaluation, such as when a neurologist seeks to reveal abnormalities not evident on routine recording.
Medicare pays $376.77–$412.13 for 95954 in the office in Oregon, from Rest Of Oregon to Portland. 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 95954 covers
This service involves using a medication during EEG testing to provoke or enhance electrical findings relevant to the diagnostic question, often in seizure evaluation. A neurologist or other qualified physician directs the provocation and interprets the tracing; an EEG technologist typically applies electrodes and operates the recording equipment. It may be performed in an outpatient EEG laboratory or during a hospital-based diagnostic evaluation. The medication-related activation is distinct from simply recording a patient who takes their usual medication.
Report the service when the record supports a deliberate medication-based activation during EEG testing, including the clinical purpose, medication administered, and resulting EEG observations. CMS recognizes professional and technical portions: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The professional and technical portions are separately priced in the CMS fee schedule. The documentation should connect the medication administration to the EEG procedure rather than describe medication management alone.
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 95954 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $412.13 | Unavailable |
| Rest Of Oregon | $376.77 | Unavailable |
How the 95954 rate is calculated
Each of 95954’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 · 95954
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.39Practice expense 8.82Malpractice 0.15
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 95954
The CMS indicators that decide how 95954 is paid alongside other services.
CMS payment indicators · 95954
EEG activation
| 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
95954 without 26 · national office
$379.43
EEG activation
95954-26 · Professional component
$106.21
Pays only the interpretation and report.
95954 compared with similar codes
Compare codes
95954 vs 95816 vs 95819 vs 95955 vs 95957: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 95816EEG
- This code concerns medication used to provoke EEG findings. Code 95816 describes a routine awake or drowsy EEG without that activation.
- 95819EEG
- Code 95819 describes a routine EEG with awake and asleep recording. Choose this code when the distinguishing service is medication-based activation during EEG testing.
- 95955Intraoperative EEG
- Code 95955 is for EEG monitoring during surgery. This code concerns medication-based activation in diagnostic EEG testing, not intraoperative monitoring.
- 95957EEG analysis
- Code 95957 represents digital analysis of EEG data. This code represents medication-based activation; analysis alone does not establish that activation service.
95954 billing questions
When is this code appropriate instead of a routine EEG code?
Use it for medication-based provocation performed as part of diagnostic EEG testing. A routine recording without that activation is represented by the applicable routine EEG code.
What documentation supports reporting the service?
Document why medication-based activation was performed, the medication administered, and the EEG findings or response. The record should show that the medication was used to affect the diagnostic recording.
How should the professional and technical portions be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical work, including equipment and staff. Without either modifier, the claim represents the global service.
Does this code represent medication management by itself?
No. The service is tied to medication used to provoke findings during EEG testing; medication administration or management without the EEG activation service is not described by this code.
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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