How much does Medicare pay for CPT 95718?

Medicare allowed an average of $133.06 per service and paid $104.84 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $563.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 95718?

Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional. It was billed 30,826 times to 27,769 Medicare beneficiaries by 924 providers in 2024.

Does 95718 pay differently in an office than a hospital?

Yes. The allowed amount averaged $129.00 in an office setting and $133.34 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 95718 most?

Neurology, with 29,598 services from 885 clinicians. Next are Neuropsychiatry, Epileptologists, Sleep Medicine.

CPT 95718

Measurement of brain wave activity with video (veeg), 2-12 hours with review and report by health care professional

$133.06Medicare-allowed amount per service, averaged across 30,826 services

Providers submitted

$563.65

Asking price, not received

Medicare allowed

$133.06

The fee schedule figure

Medicare paid

$104.84

Balance is patient coinsurance

Providers submitted an average of $563.65 for this code and Medicare allowed $133.06 — 4.2× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $104.84 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $129.00
Hospital / facility: $133.34

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 2,036 services were billed in an office setting and 28,790 in a facility.

Services: 30,826
Beneficiaries: 27,769
Providers billing it: 924
Total allowed: $4,101,708

What Medicare pays for CPT 95718

Across 30,826 services billed by 924 providers to 27,769 beneficiaries, Medicare allowed an average of $133.06 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 95718

Specialty	Services	Beneficiaries	Avg allowed	Providers
Neurology	29,598	26,610	$133.02	885
Neuropsychiatry	394	385	$139.61	9
Epileptologists	322	294	$132.90	12
Sleep Medicine	122	111	$130.52	2
Independent Diagnostic Testing Facility (IDTF)	81	81	$130.26	2
Psychiatry	66	62	$129.35	3
Critical Care (Intensivists)	56	54	$125.95	2
Neurosurgery	45	38	$126.08	2
Undefined Physician type	37	37	$132.81	2
Pediatric Medicine	37	37	$148.25	2
Family Practice	29	23	$121.06	1
Hospitalist	20	19	$133.80	1
Rheumatology	19	18	$121.71	1

95718 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	3,444	$136.65	$102.20	75
New York	3,302	$147.69	$102.79	93
Texas	1,993	$129.93	$102.72	53
Ohio	1,781	$127.22	$102.57	56
New Jersey	1,602	$140.95	$103.00	34
Pennsylvania	1,414	$132.09	$102.38	41
Michigan	1,346	$130.93	$97.53	42
Tennessee	1,226	$123.02	$100.69	30
Illinois	1,213	$137.76	$101.59	30
Florida	1,098	$133.36	$102.56	43
Virginia	1,074	$132.77	$102.72	28
North Carolina	1,007	$124.81	$102.86	35
Massachusetts	992	$138.93	$102.47	43
Minnesota	862	$128.62	$103.27	28
Alabama	743	$121.82	$101.02	19
Arizona	523	$127.05	$101.52	18
Georgia	512	$131.17	$102.83	27
Colorado	503	$129.21	$103.16	14
Maryland	480	$138.02	$102.71	17
South Carolina	435	$125.03	$101.91	18
Kentucky	431	$125.35	$102.51	12
Missouri	427	$127.92	$101.89	21
Connecticut	418	$137.13	$102.99	10
Utah	413	$126.42	$102.47	8
Wisconsin	382	$124.36	$102.48	16
Kansas	349	$125.50	$102.09	8
New Hampshire	310	$128.33	$102.19	7
Washington	288	$140.23	$103.74	12
Indiana	250	$122.76	$102.77	9
Iowa	229	$122.41	$100.49	7
Oklahoma	220	$123.86	$102.92	6
Nebraska	166	$126.08	$101.40	5
Vermont	151	$126.13	$100.44	4
Louisiana	147	$125.59	$102.13	7
New Mexico	136	$131.42	$102.96	6
Delaware	113	$129.75	$103.34	5
District of Columbia	110	$145.82	$103.35	4
Maine	102	$150.65	$103.47	1
Nevada	101	$128.26	$102.67	5
Oregon	96	$129.79	$103.34	3
Rhode Island	76	$132.31	$101.98	5
Arkansas	72	$120.72	$103.50	4
North Dakota	69	$123.77	$103.99	4
West Virginia	64	$130.44	$101.00	4
Idaho	60	$117.72	$103.21	4
Mississippi	57	$120.60	$98.93	2
South Dakota	39	$125.59	$103.35	1

Related codes

95720Measurement of brain wave activity$206.05
95715Measurement of brain wave activity$979.19
95700Measurement of brain wave activity (eeg)$249.73
95708Measurement of brain wave activity (eeg)$218.43
95717Measurement of brain wave activity (eeg)$106.45
95716Measurement of brain wave activity$1217.54
95719Measurement of brain wave activity (eeg)$162.59
95724Measurement of brain wave activity$307.92
95713Measurement of brain wave activity$567.17
95714Measurement of brain wave activity$239.19
95709Measurement of brain wave activity (eeg)$791.85
95723Measurement of brain wave activity (eeg)$249.20

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.