Neurology Billing Cheat Sheet (2026)
Neurology revenue concentrates in electrodiagnostic testing, and that is where the unit and bundling rules are strictest. Nerve conduction studies are counted, EMG is billed by extremity, and the professional and technical split decides what the practice actually keeps.
Quick reference for neurology billers. Last updated .
Top Neurology CPT Codes & 2026 Medicare Allowables
| Code | Description | Non-Facility | Facility | Total RVU |
|---|---|---|---|---|
| 95860 | Needle EMG, one extremity | $119.58 | $119.58 | 3.58 |
| 95870 | Needle EMG, limited study | $86.51 | $86.51 | 2.59 |
| 95816 | Electroencephalogram (EEG), 20-40 minutes | $413.50 | $413.50 | 12.38 |
| 95810 | Polysomnography with 4 or more parameters | $673.70 | $673.70 | 20.17 |
| 99213 | Established patient office visit, low MDM | $95.19 | $57.45 | 2.85 |
| 99214 | Established patient office visit, moderate MDM | $135.61 | $84.50 | 4.06 |
| 99215 | Established patient office visit, high MDM | $192.39 | $125.59 | 5.76 |
National 2026 Medicare Physician Fee Schedule estimates (total RVU multiplied by the conversion factor). These are adjusted by state locality. See the per-state table on the Neurology billing services page.
Modifiers That Prevent Neurology Denials
Splitting the professional interpretation from the technical component on EMG, NCS, and EEG when the practice does not own both.
A significant, separately identifiable E/M on the same day as electrodiagnostic testing.
A distinct study separate from another that NCCI would otherwise bundle, such as separate nerve studies.
Synchronous telehealth E/M for follow-up where the payer allows it, matched to the place of service.
A repeat study by the same physician with the medical reason documented.
Multiple procedures in the same session applied to secondary procedures per payer rules.
Top Neurology Denials → Quick Fix
Document each nerve studied. The NCS code set is counted by the number of studies; the report must list them to support the units.
Needle EMG is billed by extremity (95860 series). Document each limb tested so the code matches the work.
When the practice reads but does not own the equipment, bill the professional component with modifier 26 so the interpretation is not lost.
Append modifier 25 to the E/M and document an evaluation distinct from the decision to test.
Link the seizure, syncope, or neurological indication for 95816. Routine or screening EEG without an indication is denied.
NCCI Bundling Watch-Outs
Code pairs from this specialty's set that carry NCCI edits. Billing both without a justified modifier triggers a bundling denial.
| Code | Bundles With | Rationale |
|---|---|---|
| 95860 | 36591 | CPT Manual or CMS manual coding instruction |
| 95860 | 36592 | CPT Manual or CMS manual coding instruction |
| 95870 | 36591 | CPT Manual or CMS manual coding instruction |
| 95870 | 36592 | CPT Manual or CMS manual coding instruction |
| 95816 | 0543T | Misuse of Column Two code with Column One code |
| 95816 | 0544T | Misuse of Column Two code with Column One code |
| 95810 | 0903T | Misuse of Column Two code with Column One code |
| 95810 | 0904T | Misuse of Column Two code with Column One code |
Documentation That Holds Up on Appeal
Each nerve studied and the type (motor, sensory, F-wave), since the unit count comes from the studies performed.
Each extremity or the limited muscles tested, since the code is extremity-based.
The clinical indication and the recording duration.
Whether the practice owns the equipment and read the study, to support the global, technical, or professional split.
A standalone E/M note distinct from the testing decision, supporting modifier 25.
Revenue Neurology Practices Leave on the Table
Billing NCS unit counts the report does not enumerate, which fails audit.
Losing the professional component on in-office EMG, NCS, and EEG by not appending modifier 26.
Dropping the same-day E/M into the testing instead of supporting it with modifier 25.
Not capturing all nerves and extremities actually studied, undercoding high-effort electrodiagnostic sessions.
Neurology Billing FAQ
How are nerve conduction studies counted?
By the number of studies performed. The 2026 NCS code set is unit-based, and the report has to list each nerve and study type to support the units billed.
How is needle EMG billed?
By extremity. The documentation has to identify each limb tested so the 95860 series code matches the work performed.
How do we keep the interpretation fee?
Bill the professional component with modifier 26 when the physician reads a study performed on equipment the practice does not own. Otherwise the read is absorbed and lost.
Can I bill an E/M with same-day testing?
Yes, with modifier 25 and an E/M note distinct from the decision to test. Without the separate documentation it bundles into the procedure.
Stop Losing Neurology Revenue to Preventable Denials
Our AAPC-certified neurology coders apply every rule on this sheet to your claims. Call 888-701-6090 for a free billing assessment.