Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 95813 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.
Extended Brain Wave Test (Eeg), Additional Time For An Eeg (Electroencephalogram) Where The Electrical Activity In The Brain Is Recorded Using An Instrument. Wires From The Recorder Are Attached To The Scalp Using Patches (Electrodes).
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Neurology and Neuromuscular Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital 21 - Inpatient 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 95813 |
| Medicaid Fee Schedule | $386.915 median of the 8 states in the free preview · View Medicaid rates for 95813 |
National average reimbursement for CPT 95813 by major payers:
$476.02
$492.28
$557.38
$649.94
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 95813.
CPT 95813
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Midlands, Prisma Health Baptist Parkridge Hospital
Prisma Health-Midlands
$1,871.81Published rateMichael Guillette
Aztec Urgent Care LLC
$616.89Published rateCindy Chang
Miguel A Arenas Md PC
$395.07Published rateBeaumont Mri Inc, American Health Imaging Of Beaumont
Beaumont Mri Inc
$229.85Published rateMolecular Imaging Of Suburban Chicago, LLC
Molecular Imaging Of Suburban Chicago LLC
$93.34Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 95813 vs. Other Neurology and Neuromuscular Procedures Codes
The CPT 95813 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 95813 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 |
|---|---|---|
| 95812-CPT | Moderate | Extended Brain Wave Test (Eeg), Additional Time For An Eeg (Electroencephalogram) Where The Electrical Activity In The Brain Is Recorded Using An Instrument. Wires From The Recorder Are Attached To The Scalp Using Patches (Electrodes). |
| 95813-CPT | Moderate | Extended Brain Wave Test (Eeg), Additional Time For An Eeg (Electroencephalogram) Where The Electrical Activity In The Brain Is Recorded Using An Instrument. Wires From The Recorder Are Attached To The Scalp Using Patches (Electrodes). |
| 95816-CPT | Moderate | Electroencephalogram (Eeg) Inc, Electroencephalogram (Eeg) Including Recording Awake Anddrowsy With Hyperventilation Andor Photic Stimulation |
| 95819-CPT | Moderate | Electroencephalogram (Eeg) Inc, Electroencephalogram (Eeg) Including Recording Awake Andasleep With Hyperventilation Andor Photic Stimulation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 95813. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 95813 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 95813) and we'll show you how you compare in 15 minutes or less.