CPT 95803
Global XXX ActiveActigraphy testing
CPT 95803 Billing & Documentation Guide
CPT code 95803 (Actigraphy testing) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.88, a non-facility practice expense RVU of 3.12, and a malpractice RVU of 0.05, a total non-facility RVU of 4.05 and facility RVU of 4.05. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $140.18, though rates vary from $119.77 to $183.79 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95803, 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 95803 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 95803 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 95803
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.88 | 0.88 |
| Practice Expense RVU | 3.12 | 3.12 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 4.05 | 4.05 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95803
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 | $154.66 | $154.66 | $145 - $183.79 | 29 |
| Florida | $137.2 | $137.2 | $131.53 - $142.1 | 3 |
| Georgia | $130.85 | $130.85 | $124.34 - $137.36 | 2 |
| Illinois | $133.38 | $133.38 | $127.15 - $139.58 | 4 |
| Michigan | $129.6 | $129.6 | $126.42 - $132.77 | 2 |
| North Carolina | $127.69 | $127.69 | $127.69 - $127.69 | 1 |
| New York | $149.32 | $149.32 | $129.57 - $158.28 | 5 |
| Ohio | $126.22 | $126.22 | $126.22 - $126.22 | 1 |
| Pennsylvania | $133.52 | $133.52 | $126.64 - $140.4 | 2 |
| Texas | $133.7 | $133.7 | $125.78 - $141.19 | 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 95803
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95803 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 98975 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 98976 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 98977 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 99453 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 99454 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 99473 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 95803
What does CPT code 95803 mean? +
CPT code 95803 represents: Actigraphy testing. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95803? +
The 2026 Medicare national average non-facility payment for CPT 95803 is $140.18. Rates range from $119.77 to $183.79 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95803? +
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 95803? +
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 May 31, 2026.
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