CPT 95719
Global XXX ActiveEeg phys/qhp ea incr w/o vid
CPT 95719 Billing & Documentation Guide
CPT code 95719 (Eeg phys/qhp ea incr w/o vid) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.93, a non-facility practice expense RVU of 1.78, and a malpractice RVU of 0.23, a total non-facility RVU of 4.94 and facility RVU of 4.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $168.49, though rates vary from $152.89 to $214.35 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95719, 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 95719 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 95719 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 95719
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.93 | 2.93 |
| Practice Expense RVU | 1.78 | 0.85 |
| Malpractice RVU | 0.23 | 0.23 |
| Total RVU | 4.94 | 4.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95719
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 | $175.89 | $139.13 | $168.81 - $198.48 | 29 |
| Florida | $172.47 | $141.3 | $166.25 - $179.18 | 3 |
| Georgia | $163.92 | $134.29 | $160.05 - $167.79 | 2 |
| Illinois | $170.33 | $140.32 | $164.15 - $175.93 | 4 |
| Michigan | $164.51 | $135.34 | $160.82 - $168.19 | 2 |
| North Carolina | $158.24 | $129.26 | $158.24 - $158.24 | 1 |
| New York | $179.28 | $144.62 | $159.75 - $189.08 | 5 |
| Ohio | $159.89 | $131.53 | $159.89 - $159.89 | 1 |
| Pennsylvania | $165.19 | $134.77 | $159.7 - $170.68 | 2 |
| Texas | $164.07 | $133.49 | $159.1 - $168.26 | 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 95719
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95719 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 |
| 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 |
| 95940 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95719
What does CPT code 95719 mean? +
CPT code 95719 represents: Eeg phys/qhp ea incr w/o vid. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95719? +
The 2026 Medicare national average non-facility payment for CPT 95719 is $168.49. Rates range from $152.89 to $214.35 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95719? +
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 95719? +
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 1, 2026.
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