$131.10–$147.58
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.
On this page
CMS RVU26D · Effective 2026-10-01
95803 Actigraphy testing Medicare reimbursement rates in Texas
Reports actigraphy recording and analysis over at least 72 hours to assess sleep-wake patterns, such as in insomnia or circadian rhythm evaluation. Compare 95803 office and facility rates across CMS payment localities in Texas.
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 95803 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
$125.78–$141.19
8 of 8 localities have a supported rate.
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.
Where 95803 pays more and less in Texas
8 payment localities
$125.78 to $141.19
Sleep medicine
About 95803: Actigraphy sleep-wake pattern assessment
Reports actigraphy recording and analysis over at least 72 hours to assess sleep-wake patterns, such as in insomnia or circadian rhythm evaluation.
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.
CMS billing rules for 95803
- 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 RVU0.88 · 22%
- Practice expense (office) RVU3.12 · 77%
- Malpractice RVU0.05 · 1%
131
Medicare services in 2024 · #4666 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.
95803 compared with similar codes
Office rates for Texas, from the same CMS release.
$440.09–$504.29
95805 measures physiologic sleep propensity with a multiple sleep latency test. Actigraphy instead records movement-based sleep-wake patterns over an extended period.
$96.69–$107.15
95806 is an unattended sleep study with respiratory effort monitoring. It evaluates a different question from actigraphy’s assessment of sleep-wake patterns.
$620.56–$706.71
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.
Compare 95803 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office $141.19 | Facility Unavailable |
| Beaumont | Office $125.78 | Facility Unavailable |
| Brazoria | Office $134.20 | Facility Unavailable |
| Dallas | Office $134.88 | Facility Unavailable |
| Fort Worth | Office $133.86 | Facility Unavailable |
| Galveston | Office $134.49 | Facility Unavailable |
| Houston | Office $135.41 | Facility Unavailable |
| Rest Of Texas | Office $129.80 | Facility Unavailable |
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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 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.
12,52695801,,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
12,52795801,26,Slp stdy unatnd w/anal,A,,0.83,0.36,,0.36,,0.04,1.23,1.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,52895801,TC,Slp stdy unatnd w/anal,A,,0.00,1.86,,1.86,NA,0.02,1.88,1.88,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,52995803,,Actigraphy testing,A,,0.88,3.12,,3.12,NA,0.05,4.05,4.05,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53095803,26,Actigraphy testing,A,,0.88,0.36,,0.36,,0.04,1.28,1.28,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,53195803,TC,Actigraphy testing,A,,0.00,2.76,,2.76,NA,0.01,2.77,2.77,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,53295805,,Multiple sleep latency test,A,,1.17,13.02,,13.02,NA,0.17,14.36,14.36,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00