CPT 95805
Global XXX ActiveMultiple sleep latency test
CPT 95805 Billing & Documentation Guide
CPT code 95805 (Multiple sleep latency test) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.17, a non-facility practice expense RVU of 13.02, and a malpractice RVU of 0.17, a total non-facility RVU of 14.36 and facility RVU of 14.36. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $498.59, though rates vary from $415.56 to $673.52 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95805, 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 95805 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 95805 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 95805
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.17 | 1.17 |
| Practice Expense RVU | 13.02 | 13.02 |
| Malpractice RVU | 0.17 | 0.17 |
| Total RVU | 14.36 | 14.36 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95805
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 | $558.14 | $558.14 | $519.42 - $673.52 | 29 |
| Florida | $486.46 | $486.46 | $463.36 - $506.15 | 3 |
| Georgia | $460.81 | $460.81 | $433.76 - $487.85 | 2 |
| Illinois | $470.27 | $470.27 | $445 - $496.04 | 4 |
| Michigan | $455.42 | $455.42 | $442.53 - $468.31 | 2 |
| North Carolina | $448.45 | $448.45 | $448.45 - $448.45 | 1 |
| New York | $533.81 | $533.81 | $456.21 - $569.2 | 5 |
| Ohio | $441.85 | $441.85 | $441.85 - $441.85 | 1 |
| Pennsylvania | $471.47 | $471.47 | $443.66 - $499.27 | 2 |
| Texas | $472.71 | $472.71 | $440.09 - $504.29 | 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 95805
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95805 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0089T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0178T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0295T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0296T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0297T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0298T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 95805
What does CPT code 95805 mean? +
CPT code 95805 represents: Multiple sleep latency test. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95805? +
The 2026 Medicare national average non-facility payment for CPT 95805 is $498.59. Rates range from $415.56 to $673.52 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95805? +
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 95805? +
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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