Neurology CPT Codes: EEG, EMG and Nerve Studies

Neurology practices bill mainly from three parts of the CPT code set: office and hospital visits (E/M codes), the neurology and neuromuscular codes in the Medicine section (EEG, needle EMG, nerve conduction studies, sleep testing and neurobehavioral testing), and the nervous system codes in the Surgery section for spine procedures, nerve blocks and neurosurgery. The diagnostic tests are chosen by what was actually recorded: the type and length of an EEG, the number of extremities examined by EMG, and the number of nerve conduction studies. Most of them also split into a professional and a technical component.

The rules below are Medicare's, from the National Correct Coding Initiative (NCCI) policy manual, CMS's add-on code edits and the Physician Fee Schedule files. Commercial payers and Medicaid plans set their own policies, and several Medicare Administrative Contractors (MACs) have local coverage determinations (LCDs) for nerve conduction studies and EMG. Payment varies by payer and locality; for Medicare, use the Physician Fee Schedule look-up.

What are the main neurology code groups?

Common examples, described in our own words:

All of these codes are active in the 2026 Medicare fee schedule, except that the technical long-term EEG codes (95700 to 95716) are priced by each MAC rather than nationally. For home sleep testing, Medicare also has HCPCS codes G0398 to G0400, which MACs price. The spine procedures above carry a 090 global period, and the spinal injections a 000 global period, in 2026. For nerve blocks and other injections, see the injection CPT codes guide.

How are EEG codes chosen?

By what the study recorded and for how long:

• Routine EEG codes are chosen by the patient's state during the recording (awake and drowsy, awake and asleep, or sleep or coma only).
• Extended EEG codes are chosen by the length of the recording. The record must state it.
• Long-term EEG monitoring codes (95700 to 95726) separate the setup, the technical recording (by duration, with or without video, and by the level of technologist monitoring) and the physician's review and report (by the length of the study). Each piece has to be documented and billed by the party that performed it.

The NCCI manual adds limits for EEG with sleep testing. Polysomnography already includes EEG electrodes, so a diagnostic EEG isn't reported with it unless a complete EEG was done at a separate encounter on the same day, with modifier 59 or XE. Long-term EEG monitoring can be reported with sleep testing only when it was a significant, separately identifiable service, with modifier 59 or XU.

How are EMG and nerve conduction studies billed together?

Needle EMG and nerve conduction studies (NCS) are often done at the same session, and the codes reflect that:

• Nerve conduction studies (95907 to 95913) are chosen by the total number of studies performed. Count and document each study.
• Needle EMG with NCS. CMS's add-on code edit file lists the nerve conduction codes 95907 to 95913 as the primary codes for the add-on EMG codes 95885, 95886 and 95887, which describe needle EMG performed with a nerve conduction study.
• Needle EMG alone is reported with 95860 to 95864, by the number of extremities examined.

MAC LCDs for NCS and EMG set out when the tests are covered, what the report must include, and who is expected to perform them. For example, the CGS LCD says both tests are usually needed to diagnose peripheral nerve disorders and expects the professional performing them to have specific training in electrodiagnostic medicine. Check your MAC's LCD and its billing article before billing these tests.

Some rules apply across the group. Nerve testing done only to check the level of paralysis during anesthesia or mechanical ventilation isn't separately reportable. Stimulating a nerve to locate it during a nerve block or other nerve procedure is part of that procedure. And the surgeon doesn't report intraoperative neurophysiology testing or monitoring, because it is included in the surgery; a different physician monitoring the case can.

What rules apply to sleep testing and neurobehavioral exams?

• Sleep studies and polysomnography differ: polysomnography includes sleep staging. The two aren't reported for the same encounter.
• Neurobehavioral status exam (96116, 96121) isn't reported when only a mini-mental status exam was done; that is part of the visit. It isn't reported with a psychiatric diagnostic evaluation (90791 or 90792), and it is reported with a visit only when a complete neurobehavioral status exam was performed.

What bundling rules affect spine and nerve procedures?

The NCCI manual's nervous system section includes these rules:

• Injections inside larger spine procedures. Epidural and subarachnoid injection codes (62320 to 62327) are included in the codes for more invasive spinal procedures.
• Imaging guidance. The injection codes that include imaging guidance (62321, 62323, 62325 and 62327) already include fluoroscopic or CT guidance, so a separate guidance code isn't reported.
• Levels. In code families with a primary code and an add-on code, contiguous levels are reported with one primary code for the first level and the add-on code for each additional level.
• Laminotomy and laminectomy. A laminotomy isn't reported with a laminectomy on the same vertebra.
• Dural repair. Repairing a dural leak that occurs during a spinal or cranial procedure is part of that procedure.

Spine surgery also carries Medicare's global surgery rules; the surgery CPT codes guide explains them. When two services really are distinct, a modifier such as 59, XE, XS or XU is used only when the record shows it; the CO-97 guide covers how bundling denials arise.

Where do neurology claims go wrong?

• Counts and durations that don't match the report: the number of nerve conduction studies, the extremities tested by EMG, or the length of an EEG recording.
• The wrong EMG code when EMG and nerve conduction studies were done at the same session.
• Components billed twice or not at all, such as a global EEG billed when the practice only interpreted the study.
• Coverage: tests without the indications or diagnosis codes the MAC's LCD requires.
• Bundled services billed separately, such as imaging guidance with injection codes that include it.

For billing support, see Highview's physician billing service.

Sources

• CMS, Medicare NCCI Policy Manual (effective January 1, 2026): Chapter 11, sections L (neurology and neuromuscular procedures) and M (central nervous system assessments), and Chapter 8, section C (nervous system).
• CMS, Medicare NCCI Add-on Code Edits (effective October 1, 2026): primary codes for 95885, 95886 and 95887.
• CMS, PFS Relative Value Files, RVU26D: 2026 status, global periods and PC/TC indicators for the codes listed.
• CGS Administrators, LCD L35897, Nerve Conduction Studies and Electromyography (revision effective May 7, 2026): an example of a MAC coverage policy for NCS and EMG.
• CMS, Search the Physician Fee Schedule.