CPT 95808
Global XXX ActivePolysom any age 1-3> param
CPT 95808 Billing & Documentation Guide
CPT code 95808 (Polysom any age 1-3> param) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.7, a non-facility practice expense RVU of 13.44, and a malpractice RVU of 0.2, a total non-facility RVU of 15.34 and facility RVU of 15.34. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $532.16, though rates vary from $445.83 to $713.93 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95808, 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 95808 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 95808 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 95808
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.7 | 1.7 |
| Practice Expense RVU | 13.44 | 13.44 |
| Malpractice RVU | 0.2 | 0.2 |
| Total RVU | 15.34 | 15.34 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95808
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 | $593.62 | $593.62 | $553.33 - $713.93 | 29 |
| Florida | $520.19 | $520.19 | $495.98 - $540.99 | 3 |
| Georgia | $493.12 | $493.12 | $465.17 - $521.07 | 2 |
| Illinois | $503.5 | $503.5 | $477.08 - $530.04 | 4 |
| Michigan | $487.71 | $487.71 | $474.18 - $501.24 | 2 |
| North Carolina | $479.88 | $479.88 | $479.88 - $479.88 | 1 |
| New York | $569.36 | $569.36 | $487.94 - $606.57 | 5 |
| Ohio | $473.37 | $473.37 | $473.37 - $473.37 | 1 |
| Pennsylvania | $504.14 | $504.14 | $475.19 - $533.09 | 2 |
| Texas | $505.25 | $505.25 | $471.49 - $537.76 | 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 95808
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95808 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 |
| 0243T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0244T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0295T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0296T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0297T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0298T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 95808
What does CPT code 95808 mean? +
CPT code 95808 represents: Polysom any age 1-3> param. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95808? +
The 2026 Medicare national average non-facility payment for CPT 95808 is $532.16. Rates range from $445.83 to $713.93 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95808? +
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 95808? +
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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