CPT 95709 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Long-term EEG Monitoring Special EEG Testing Procedures |
| Common Place of Service | 11 - Office 15 - Mobile Unit |
| Common Modifiers | None TC - Technical component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 95709 |
National average reimbursement for CPT 95709 by major payers:
$793.23
$880.53
$819.17
$1,182.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 95709 | $647.09 | 1275564197 - PAUL BERKOWITZ | 363330928 - (IL) PRESENCE HEALTHCARE SERVICES | FL | Psychiatry Physician (2084P0800X) |
United | 95709 | $727.34 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 95709 | $1193.30 | 1932216702 - ANAND KUMAR | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $1529.56 | 1295769297 - YOLANDA HOLLER-MANAGAN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95709 | $762.84 | 1407807746 - SYED KHAN | 320552496 | IN | Psychiatry Physician (2084P0800X) |
United | 95709 | $610.60 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | AZ | Psychiatry Physician (2084P0800X) |
United | 95709 | $897.90 | 1023112745 - NELDA AKINBILE | 860285857 - EL RIO SANTA CRUZ NEIGHBORHOOD HEALTH CENTER INC | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $668.96 | 1366540072 - DHRUV PATEDER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery of the Spine Physician (207XS0117X) |
United | 95709 | $890.58 | 1528695681 - MAYA CLOYD | 351913875 - INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS | IN | Psychiatry Physician (2084P0800X) |
United | 95709 | $1231.11 | 1275562779 - BARRY RABIN | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95709 | $727.34 | 1306340880 - GEORGE GIANAKAKOS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | FL | Psychiatry Physician (2084P0800X) |
United | 95709 | $788.53 | 1700226206 - ALIESJE SORGELOOS | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95709 | $731.28 | 1487755955 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 95709 | $946.25 | 1497080584 - ELIZABETH HOMAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | MN | Psychiatry Physician (2084P0800X) |
United | 95709 | $1650.94 | 1992122410 - DIVAKAR MITHAL | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 95709 vs. Other Special EEG Testing Procedures Codes
The CPT 95709 code is part of the Long-term EEG Monitoring services used for Special EEG Testing Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 95709 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 95709-CPT | Moderate | Eeg W O Vid Ea 12 26hr Intmt, Electroencephalogram Eeg Without Video Review Of Data Technical Description By Eeg Technologist Each Increment Of 12 26 Hours With Intermittent Monitoring And Maintenance |
| 95710-CPT | Moderate | Eeg W O Vid Ea 12 26hr Cont, Electroencephalogram Eeg Without Video Review Of Data Technical Description By Eeg Technologist Each Increment Of 12 26 Hours With Continuous Real Time Monitoring And Maintenance |
| 95717-CPT | Low | Eeg Phys Qhp 2 12 Hr W O Vid, Electroencephalogram Eeg Continuous Recording Physician Or Other Qualified Health Care Professional Review Of Recorded Events Analysis Of Spike And Seizure Detection Interpretation And Report 2 12 Hours Of Eeg Recording Without Video |
| 95718-CPT | Low | Eeg Phys Qhp 2 12 Hr W Veeg, Electroencephalogram Eeg Continuous Recording Physician Or Other Qualified Health Care Professional Review Of Recorded Events Analysis Of Spike And Seizure Detection Interpretation And Report 2 12 Hours Of Eeg Recording With Video Veeg |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95709. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95709 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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