CPT 95808 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 | • Medicine Services and Procedures • Neurology and Neuromuscular Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 95808 by major payers:
$623.42
$818.42
$810.75
$991.45
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 95808 | ||||||
United | 95808 | $169.30 | 1952460933 - LARISSA CHISM BUGGS | 810231784 - BILLINGS CLINIC | IL | Psychiatry Physician (2084P0800X) |
United | 95808 | $551.76 | 1225065220 - RAKESH CHANDRA | 371041283 - (IL) CHRISTOPHER GREATER AREA RURAL HEALTH PLANNING CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 95808 | $1414.41 | 1225211600 - JOHN MILLICHAP | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95808 | $954.46 | 1285719260 - TANMOY CHANDRA | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 95808 | $1750.75 | 1568752665 - ANDREW KNOX | 391678306 - AURORA MEDICAL GROUP INC | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95808 | $1218.88 | 1386800662 - NICHOLAS HATZIS | 364187449 | IL | Psychiatry Physician (2084P0800X) |
United | 95808 | $898.85 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 95808 | $1231.17 | 1881918415 - TUSHAR ADVANI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MT | Psychiatry Physician (2084P0800X) |
United | 95808 | $1231.17 | 1760412621 - RHONDA LAMPEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 95808 | $781.54 | 1902917818 - FAZAL AHMED | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 95808 | $817.08 | 1144420365 - ALMA RAMIC | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | IL | Psychiatry Physician (2084P0800X) |
United | 95808 | $165.72 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | PA | Psychiatry Physician (2084P0800X) |
United | 95808 | $1329.33 | 1740252972 - DAVID HSU | 390884478 - BELLIN MEMORIAL HOSPITAL INC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 95808 | $1038.66 | 1235440058 - CAROLYN DOYLE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | CA | Psychiatry Physician (2084P0800X) |
United | 95808 | $777.09 | 1780651588 - PATRICIA MUMBY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
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 95808 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95808 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 95808 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 |
|---|---|---|
| 95782-CPT | High | Polysomnography; Younger Than 6 Years Sleep Staging With 4 Or More Additional Parameters Of Sleep Attended By A Technologist |
| 95783-CPT | High | Polysomnography; Younger Than 6 Years Sleep Staging With 4 Or More Additional Parameters Of Sleep With Initiation Of Continuous Positive Airway Pressure Therapy Or Bi-Level Ventilation Attended By A Technologist |
| 95807-CPT | Moderate | Sleep Study, Simultaneous Recording Of Ventilation, Respiratory Effort, Ecg Or Heart Rate, And Oxygen Saturation, Attended By A Technologist |
| 95808-CPT | Moderate | Polysomnography; Any Age Sleep Staging With 1-3 Additional Parameters Of Sleep Attended By A Technologist (Revised 01/01/13) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95808. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95808 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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