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See a sample rate comparisonCPT 95805 Fee Schedule
Last Verified: October 2026
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.
Sleep Study, Nap Study To See How Quickly A Person Falls Asleep During The Day. Measures The Level Of Daytime Sleepiness. Standard Test For Narcolepsy And To Check If Rem Sleep Occurs. Usually Done Right After An Overnight Sleep Study.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $479.64 national non-facility rate (2026) · View Medicare rates for 95805 |
| Medicaid Fee Schedule | $385.935 median of the 8 states in the free preview · View Medicaid rates for 95805 |
National average reimbursement for CPT 95805 by major payers:
$501.16
$573.41
$598.34
$725.49
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CPT 95805
5 of 25 sample ratesHigher to lower in this preview
Cynthia Stack
Pediatric Faculty Foundation In
$1,005.23Published rateSteven Sharp
Loyola University Medical Center
$662.21Published rateAnn Sarpy
Thresholds Health Nfp
$420.01Published rateMartins Adeoye
$75.90Published rateAll Ways Homecare Inc
$35.00Published rate
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See a sample payer proposalCPT 95805 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95805 code is part of the Medicine Services and Procedures services used for Neurology and Neuromuscular 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 95805 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 |
|---|---|---|
| 95800-CPT | Low | Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant. |
| 95801-CPT | Low | Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant. |
| 95805-CPT | Moderate | Sleep Study, Nap Study To See How Quickly A Person Falls Asleep During The Day. Measures The Level Of Daytime Sleepiness. Standard Test For Narcolepsy And To Check If Rem Sleep Occurs. Usually Done Right After An Overnight Sleep Study. |
| 95806-CPT | Low | Sleep Study, A Sleep Study Records Information About Breathing Effort And Ability Heart Rate And Amount Of Oxygen That Is In The Blood While Sleeping. Data May Be Recorded Automatically Or By An Attendant. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95805. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95805 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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