CPT 95720
Global XXX ActiveEeg phy/qhp ea incr w/veeg
CPT 95720 Billing & Documentation Guide
CPT code 95720 (Eeg phy/qhp ea incr w/veeg) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 3.76, a non-facility practice expense RVU of 2.29, and a malpractice RVU of 0.3, a total non-facility RVU of 6.35 and facility RVU of 5.14. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $216.56, though rates vary from $196.45 to $275.36 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95720, 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 95720 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 95720 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 95720
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 3.76 | 3.76 |
| Practice Expense RVU | 2.29 | 1.08 |
| Malpractice RVU | 0.3 | 0.3 |
| Total RVU | 6.35 | 5.14 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95720
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 | $226.03 | $178.21 | $216.92 - $255.07 | 29 |
| Florida | $221.84 | $181.29 | $213.77 - $230.55 | 3 |
| Georgia | $210.74 | $172.18 | $205.76 - $215.71 | 2 |
| Illinois | $219.08 | $180.03 | $211.08 - $226.33 | 4 |
| Michigan | $211.51 | $173.56 | $206.73 - $216.29 | 2 |
| North Carolina | $203.35 | $165.65 | $203.35 - $203.35 | 1 |
| New York | $230.5 | $185.4 | $205.3 - $243.18 | 5 |
| Ohio | $205.52 | $168.62 | $205.52 - $205.52 | 1 |
| Pennsylvania | $212.35 | $172.76 | $205.27 - $219.43 | 2 |
| Texas | $210.89 | $171.1 | $204.5 - $216.33 | 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 95720
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95720 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 |
| 95719 | 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 95720
What does CPT code 95720 mean? +
CPT code 95720 represents: Eeg phy/qhp ea incr w/veeg. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95720? +
The 2026 Medicare national average non-facility payment for CPT 95720 is $216.56. Rates range from $196.45 to $275.36 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95720? +
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 95720? +
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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