CPT 95718
Global XXX ActiveEeg phys/qhp 2-12 hr w/veeg
CPT 95718 Billing & Documentation Guide
CPT code 95718 (Eeg phys/qhp 2-12 hr w/veeg) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.44, a non-facility practice expense RVU of 1.49, and a malpractice RVU of 0.2, a total non-facility RVU of 4.13 and facility RVU of 3.34. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $140.82, though rates vary from $127.69 to $178.93 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95718, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 95718 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 95718 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 95718
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.44 | 2.44 |
| Practice Expense RVU | 1.49 | 0.7 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 4.13 | 3.34 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95718
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $146.93 | $115.71 | $141.01 - $165.81 | 29 |
| Florida | $144.44 | $117.96 | $139.12 - $150.2 | 3 |
| Georgia | $137.09 | $111.92 | $133.85 - $140.33 | 2 |
| Illinois | $142.64 | $117.14 | $137.38 - $147.42 | 4 |
| Michigan | $137.64 | $112.85 | $134.48 - $140.79 | 2 |
| North Carolina | $132.2 | $107.58 | $132.2 - $132.2 | 1 |
| New York | $149.96 | $120.53 | $133.47 - $158.29 | 5 |
| Ohio | $133.67 | $109.58 | $133.67 - $133.67 | 1 |
| Pennsylvania | $138.12 | $112.27 | $133.5 - $142.74 | 2 |
| Texas | $137.15 | $111.17 | $132.99 - $140.76 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 95718
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95718 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0733T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95717 | Column 1 (primary), can be billed with modifier | No | Mutually exclusive procedures |
| 95812 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95813 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95816 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95819 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95822 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 95824 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
Frequently Asked Questions, CPT 95718
What does CPT code 95718 mean? +
CPT code 95718 represents: Eeg phys/qhp 2-12 hr w/veeg. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95718? +
The 2026 Medicare national average non-facility payment for CPT 95718 is $140.82. Rates range from $127.69 to $178.93 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95718? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 95718? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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