CPT 95938
Global XXX ActiveSomatosensory testing
CPT 95938 Billing & Documentation Guide
CPT code 95938 (Somatosensory testing) is classified under Neurology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.84, a non-facility practice expense RVU of 11.05, and a malpractice RVU of 0.09, a total non-facility RVU of 11.98 and facility RVU of 11.98. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $416.39, though rates vary from $346.64 to $564.97 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 95938, 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 95938 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 95938 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 95938
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.84 | 0.84 |
| Practice Expense RVU | 11.05 | 11.05 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 11.98 | 11.98 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 95938
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 | $467.42 | $467.42 | $434.66 - $564.97 | 29 |
| Florida | $404.22 | $404.22 | $385.42 - $419.87 | 3 |
| Georgia | $383.8 | $383.8 | $360.86 - $406.74 | 2 |
| Illinois | $390.53 | $390.53 | $369.73 - $412.63 | 4 |
| Michigan | $378.86 | $378.86 | $368.42 - $389.29 | 2 |
| North Carolina | $374.33 | $374.33 | $374.33 - $374.33 | 1 |
| New York | $445.22 | $445.22 | $380.8 - $474.27 | 5 |
| Ohio | $368.06 | $368.06 | $368.06 - $368.06 | 1 |
| Pennsylvania | $393.03 | $393.03 | $369.71 - $416.36 | 2 |
| Texas | $394.36 | $394.36 | $366.71 - $421.26 | 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 95938
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 95938 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 |
| 95925 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 95926 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 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 |
Frequently Asked Questions, CPT 95938
What does CPT code 95938 mean? +
CPT code 95938 represents: Somatosensory testing. It's in the Neurology category with a global period of XXX.
What is the Medicare reimbursement for CPT 95938? +
The 2026 Medicare national average non-facility payment for CPT 95938 is $416.39. Rates range from $346.64 to $564.97 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 95938? +
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 95938? +
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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