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See a sample rate comparisonCPT 95806 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, 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.
| 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 | Low |
| Medicare Fee Schedule | $103.21 national non-facility rate (2026) · View Medicare rates for 95806 |
| Medicaid Fee Schedule | $85.035 median of the 8 states in the free preview · View Medicaid rates for 95806 |
National average reimbursement for CPT 95806 by major payers:
$131.26
$194.09
$185.62
$212.62
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CPT 95806
5 of 25 sample ratesHigher to lower in this preview
Martin Sandler
Vanderbilt University Medical Center
$322.75Published rateCamille Robinson
Vanderbilt University Medical Center
$172.75Published rateScott Zuckerman
Vanderbilt University Medical Center
$130.80Published rateVinit Shah
$74.48Published rateVijay Saaraswat Medical LLC
Vijay Saaraswat Medical, LLC
$29.98Published rate
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See a sample payer proposalCPT 95806 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95806 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 95806 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. |
| 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. |
| 95807-CPT | Moderate | 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. |
| 95810-CPT | Moderate | Overnight Sleep Study, A Technician-Monitored Overnight Sleep Study At A Facility. Brain Activity Breathing Blood Pressure Heart Rate And Other Factors Are Measured As Well As The Quality Of Sleep. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95806. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95806 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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Frequently Asked Questions
Factors that affect CPT 95806 fee schedules include 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), and Provider Type (hospital providers may have different rates than private practice). For specific fee schedule information tailored to your location and provider, you can use a tool like Payerprice.
CPT 95806 is part of the Medicine Services and Procedures services for Neurology and Neuromuscular Procedures. It represents a moderate-complexity encounter and involves more provider time and moderate medical decision-making than lower-level codes. This typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.