CPT 95722
Global XXX ActiveEeg phy/qhp>36<60 hr w/veeg
CPT 95722 Billing & Documentation Guide
CPT code 95722 (Eeg phy/qhp>36<60 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 4.7, a non-facility practice expense RVU of 2.81, and a malpractice RVU of 0.38, a total non-facility RVU of 7.89 and facility RVU of 6.41. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $269.01, though rates vary from $244.14 to $342.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95722, 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 95722 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 95722 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 95722
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 4.7 | 4.7 |
| Practice Expense RVU | 2.81 | 1.33 |
| Malpractice RVU | 0.38 | 0.38 |
| Total RVU | 7.89 | 6.41 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95722
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 | $280.55 | $222.06 | $269.32 - $316.4 | 29 |
| Florida | $275.86 | $226.26 | $265.79 - $286.79 | 3 |
| Georgia | $261.95 | $214.79 | $255.83 - $268.06 | 2 |
| Illinois | $272.47 | $224.72 | $262.51 - $281.54 | 4 |
| Michigan | $262.98 | $216.56 | $257 - $268.96 | 2 |
| North Carolina | $252.66 | $206.54 | $252.66 - $252.66 | 1 |
| New York | $286.39 | $231.24 | $255.07 - $302.2 | 5 |
| Ohio | $255.47 | $210.34 | $255.47 - $255.47 | 1 |
| Pennsylvania | $263.9 | $215.48 | $255.14 - $272.66 | 2 |
| Texas | $262.04 | $213.37 | $254.18 - $268.9 | 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 95722
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95722 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 | CPT Manual or CMS manual coding instruction |
| 95718 | 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 | CPT Manual or CMS manual coding instruction |
| 95720 | 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 |
Frequently Asked Questions, CPT 95722
What does CPT code 95722 mean? +
CPT code 95722 represents: Eeg phy/qhp>36<60 hr w/veeg. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95722? +
The 2026 Medicare national average non-facility payment for CPT 95722 is $269.01. Rates range from $244.14 to $342.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95722? +
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 95722? +
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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