CPT
90471 — Immunization administration, single vaccine
ACA-covered vaccines should be free, including the admin fee.
Neurology
95816 — Electroencephalogram ; including recording awake and drowsy
This EEG records your brain's electrical activity through electrodes placed on your scalp while you are awake and while you are in a drowsy state.
- Typical setting: Neurologist's office, hospital outpatient
- National avg charge (illustrative): $200–$600 (combined technical and professional components; Medicare approximate rate $150–$250)
- Most-disputed reason: Billing 95816 on the same date as a polysomnography (sleep study) without documentation that both a diagnostic EEG and a sleep study were independently medically necessary and performed.
What it means
What 95816 actually means
This EEG records your brain's electrical activity through electrodes placed on your scalp while you are awake and while you are in a drowsy state. It is commonly used to evaluate seizure disorders, altered mental status, or neurological symptoms.
Common errors with this code
What goes wrong on real bills.
Most bills that look correct still contain at least one of these issues. Up to 49% of medical bills contain errors (CFPB).
- Billing 95816 on the same date as a polysomnography (sleep study) without documentation that both a diagnostic EEG and a sleep study were independently medically necessary and performed.
- Billing the EEG globally (combined technical and professional) when the recording was performed at one facility and interpreted by a neurologist at another location — each provider should bill their own component with the appropriate modifier.
- Routine follow-up EEGs billed without documentation of the specific clinical indication for repeat testing (e.g., medication change, new symptoms).
If you see 95816 on your bill
Three steps before paying.
1. Get the itemized bill. If your statement only shows a summary, request the CPT-level itemized bill before paying. Generate the request language →
2. Cross-check against the EOB. Compare what your insurer's Explanation of Benefits says you owe versus what the hospital is asking. They disagree more often than people think. Read the bill-vs-EOB guide →
3. Run a free Bill Scan. Upload the bill (and EOB if you have it) and BillBusted will flag the most likely issues with this specific code in your specific state. Run free scan →
Related codes
Other codes in this category.
People who land on 95816 often also see these adjacent codes on the same bill.
CPT
90472 — Immunization admin; each additional vaccine
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90651 — Human papillomavirus vaccine types 6, 11, 16, 18, 31, 33, 45, 52, 58, nonavalent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90670 — Pneumococcal conjugate vaccine, 13 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90671 — Pneumococcal conjugate vaccine, 15 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
CPT
90677 — Pneumococcal conjugate vaccine, 20 valent , IM
Vaccine — admin (90471) is separate from the vaccine product code.
Related BillBusted guides
Plain-English reads if you see 95816 on a bill.
95816 FAQ
Plain-English answers.
What does 95816 usually cost?
$200–$600 (combined technical and professional components; Medicare approximate rate $150–$250). Costs vary by region, payer contract, and whether the service was performed in a hospital outpatient department (which adds a facility fee) versus a free-standing clinic.
What's the most common billing error on 95816?
Billing 95816 on the same date as a polysomnography (sleep study) without documentation that both a diagnostic EEG and a sleep study were independently medically necessary and performed.
What should I do if I see 95816 on my bill?
Request the itemized bill and the matching EOB from your insurer. Compare the units/quantity billed against what you actually received. Run a free BillBusted scan to flag the most likely errors specific to 95816 before paying.
Don't pay 95816 blindly.
The free scan tells you in under 60 seconds whether this charge looks reasonable for your situation.