Reimbursement
$457.58
Threshold
N/A
2026 Status
Active
What is CPT Code 95810?
CPT 95810 is defined as: Polysomnography (PSG) is a comprehensive diagnostic study performed on patients aged 6 years or older to evaluate sleep disorders. The procedure involves continuous recording and monitoring of multiple physiological parameters including sleep staging (EEG, EOG, EMG) and at least four additional parameters such as airflow, respiratory effort, oxygen saturation, ECG, and leg movements. CPT 95810 requires the continuous physical presence of a technologist throughout the study (attended).
This code is primarily used for Specialist services. It falls under the category of Medicine / Neurology and Neuromuscular Procedures and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.
2026 RVU Components
Relative Value Units (Non-Facility)
Work RVU
4
Physician Effort
PE (Non-Fac)
9.5
Practice Expense
Malpractice
Risk Factor
Total RVU
13.7
Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor
2026 CMS Policy Intelligence
efficiency adjustment
Subject to -2.5% Efficiency Adjustment. CMS assumes that improved scoring software and automated analysis tools have increased physician efficiency in interpreting sleep studies.
facility pe reduction
Hospital-based labs (POS 22) face a 50% reduction in the indirect PE component compared to independent sleep centers (POS 11) in 2026.
conversion factor
Utilizes the 2026 Non-QP baseline of $33.40.
Administrative Framework
Place of Service
NCCI Exclusions
Key Modifiers
Operational Requirements
duration
A minimum of 6 hours of continuous recording is required for a complete study.
attendance
Must be 'attended' by a technologist. Home Sleep Apnea Tests (HSAT) should use codes like 95800 or 95806 instead.
required parameters
Must include sleep staging plus at least 4 additional parameters (e.g., airflow, effort, O2, ECG).
physician interpretation
Requires a comprehensive written report by a physician, including an analysis of sleep architecture and respiratory events.
Compliance Checklist
Audit Defense
No specific audit defense elements defined.
2026 Update
Work RVU reduced by 2.5% efficiency cut. Verify technologist credentials for local MAC compliance.
Common Clinical Scenarios
No clinical examples provided.
Target Specialties & Utilization
Typical Clinical Indications (ICD-10)
Frequently Asked Questions
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