CPT 95926
Global XXX ActiveSomatosensory testing
CPT 95926 Billing & Documentation Guide
CPT code 95926 (Somatosensory testing) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.53, a non-facility practice expense RVU of 3.49, and a malpractice RVU of 0.05, a total non-facility RVU of 4.07 and facility RVU of 4.07. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $141.15, though rates vary from $118.7 to $188.64 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95926, 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 95926 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 95926 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 95926
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.53 | 0.53 |
| Practice Expense RVU | 3.49 | 3.49 |
| Malpractice RVU | 0.05 | 0.05 |
| Total RVU | 4.07 | 4.07 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95926
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 | $157.18 | $157.18 | $146.66 - $188.64 | 29 |
| Florida | $137.91 | $137.91 | $131.65 - $143.27 | 3 |
| Georgia | $130.94 | $130.94 | $123.67 - $138.2 | 2 |
| Illinois | $133.59 | $133.59 | $126.74 - $140.5 | 4 |
| Michigan | $129.52 | $129.52 | $126.02 - $133.01 | 2 |
| North Carolina | $127.53 | $127.53 | $127.53 - $127.53 | 1 |
| New York | $150.86 | $150.86 | $129.62 - $160.54 | 5 |
| Ohio | $125.81 | $125.81 | $125.81 - $125.81 | 1 |
| Pennsylvania | $133.83 | $133.83 | $126.29 - $141.36 | 2 |
| Texas | $134.11 | $134.11 | $125.33 - $142.55 | 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 95926
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95926 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 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 |
| 00104 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00210 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00211 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00212 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00214 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00215 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 00216 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 95926
What does CPT code 95926 mean? +
CPT code 95926 represents: Somatosensory testing. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95926? +
The 2026 Medicare national average non-facility payment for CPT 95926 is $141.15. Rates range from $118.7 to $188.64 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95926? +
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 95926? +
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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