$426.19
Use 95822 for recording limited to sleep or coma. Use 95816 when the EEG includes awake and drowsy recording.
On this page
CMS RVU26D · Effective 2026-10-01
95822 EEG Medicare reimbursement rates in Rhode Island
Reports an EEG recorded only during sleep or coma, such as when evaluating seizures or abnormal brain function in a patient who is not awake. Compare 95822 office and facility rates across CMS payment localities in Rhode Island.
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 95822 in Rhode Island?
Rhode Island 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
$460.69
1 of 1 localities have a supported rate.
Payment area: Rhode Island
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.
Neurodiagnostic testing
About 95822: EEG recorded during sleep or coma
Reports an EEG recorded only during sleep or coma, such as when evaluating seizures or abnormal brain function in a patient who is not awake.
Code 95822 describes an electroencephalogram recorded while the patient is asleep or comatose, rather than an awake-and-asleep routine EEG. Scalp electrodes and EEG equipment capture cerebral electrical activity; an EEG technologist generally performs the recording, and a physician with EEG expertise interprets it. Hospital and outpatient neurodiagnostic services may use this code when the documented recording is limited to sleep or coma, including evaluations of seizures or abnormal brain function.
Choose the code based on the recording state, not just the reason for testing. An EEG that includes awake and asleep phases is reported with 95819; an awake-and-drowsy study is reported with 95816. Documentation should support the patient's state during the recording and the EEG services performed. CMS recognizes a professional component for interpretation and a technical component for equipment and staff: report modifier 26 for the professional component, modifier TC for the technical component, or neither for the global service.
CMS billing rules for 95822
- 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 RVU1.05 · 8%
- Practice expense (office) RVU12.23 · 91%
- Malpractice RVU0.10 · 1%
22.1K
Medicare services in 2024 · #1108 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.
95822 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
$497.22
Use 95822 for sleep-only or coma-only recording; 95819 describes an EEG that captures both awake and asleep phases.
$394.82
95812 identifies an EEG by its 41-to-60-minute duration. 95822 is distinguished by sleep-only or coma-only recording.
$494.14
95813 identifies an extended EEG lasting 61 to 119 minutes. 95822 is distinguished by the patient's state during recording.
Compare 95822 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
Rhode Island →
Office / nonfacility
$460.69
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 95822 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
12,562
- Code
- 95822
- Physician work
- 1.05
- Practice expense
- 12.23
- Malpractice
- 0.10
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.05 | × 1.019 | 1.0699 |
| Practice expense | 12.23 | × 1.033 | 12.6336 |
| Malpractice | 0.10 | × 0.892 | 0.0892 |
| Total RVUs | 13.7927 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Rhode Island$460.69
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.05 | 1.019 |
| Practice expense | 12.23 | 1.033 |
| Malpractice | 0.1 | 0.892 |
(1.05 × 1.019 + 12.23 × 1.033 + 0.1 × 0.892) × $33.4009 = $460.69
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.
95822 billing questions
How does 95822 differ from 95819?
95822 is for an EEG recorded during sleep or coma only. Use 95819 when the study includes both awake and asleep recording.
How does 95822 differ from 95816?
95822 describes sleep-only or coma-only recording. Code 95816 is for an EEG that includes awake and drowsy recording.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff; billing without either modifier represents the global service.
Is the code selected by recording duration?
The distinguishing feature of 95822 is that recording is limited to sleep or coma. Codes 95812 and 95813 identify EEGs by recording duration.
What should the record support?
Document that the EEG was recorded during sleep or coma, along with the recording performed and the physician's interpretation.
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.
12,55995819,,Eeg awake and asleep,A,,1.05,13.28,,13.28,NA,0.11,14.44,14.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56095819,26,Eeg awake and asleep,A,,1.05,0.60,,0.60,,0.05,1.70,1.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56195819,TC,Eeg awake and asleep,A,,0.00,12.68,,12.68,NA,0.06,12.74,12.74,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56295822,,Eeg coma or sleep only,A,,1.05,12.23,,12.23,NA,0.10,13.38,13.38,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56395822,26,Eeg coma or sleep only,A,,1.05,0.60,,0.60,,0.05,1.70,1.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56495822,TC,Eeg coma or sleep only,A,,0.00,11.63,,11.63,NA,0.05,11.68,11.68,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,56595824,,Eeg cerebral death only,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537