95705 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 95705

Payer coverage policies that name 95705

95705 appears in 11 coverage policies from Aetna, Anthem, BlueCross BlueShield of South Carolina, Centene, Cigna, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaAmbulatory Electroencephalography (0425)covered if criteria are metJul 7, 2026payer document
AetnaAttended Electroencephalographic (EEG) Video Monitoring (0322)listed, no stanceJun 8, 2026payer document
AetnaTranscranial Magnetic Stimulation and Cranial Electrical Stimulation (0469)not covered (range 95700-95726)Jul 17, 2026payer document
AnthemAmbulatory Electroencephalography (CG-MED-46)covered if criteria are metAug 13, 2026payer document
BlueCross BlueShield of South CarolinaAmbulatory or Video Electroencephalogram (EEG) Monitoring, Including Digital Analysis of Electroencephalogram (CAM 245)listed, no stanceMay 1, 2026payer document
CenteneAmbulatory Electroencephalography (CP.MP.96)covered if criteria are metJul 1, 2021payer document
CenteneAttention Deficit Hyperactivity Disorder Assessment and Treatment (CP.BH.124)not coveredMar 1, 2024payer document
CenteneAttention Deficit Hyperactivity Disorder Assessment and Treatment (CP.MP.124)not coveredFeb 1, 2022payer document
CignaAutism Spectrum Disorders/Pervasive Developmental Disorders: Assessment and Treatment (0447)covered if criteria are metMay 15, 2026payer document
CignaElectroencephalography (0521)covered if criteria are metFeb 15, 2026payer document
UnitedHealthcareAmbulatory EEG Monitoring (MMP379.12)listed, no stanceSep 1, 2026payer document

Medicaid fee-for-service

  • AZ: $191.73 (outpatient_hospital), effective Oct 1, 2025
  • CO: $273.45 (health_first_colorado), effective Jul 1, 2026
  • FL: $70.68 (physician, non-facility), effective Jan 1, 2026
  • IL: $151.86 (practitioner), effective Jan 1, 2020
  • IN: $88.10 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KS: $123.39 (default, Exempt Physician), effective Jan 1, 2020
  • KY: $0.00 (physician, facility), effective Jan 1, 2026
  • LA: $75.00 (professional), effective Jan 1, 2020
  • MS: $93.29 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • NY: $13.03 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $87.15 (physician), effective Oct 1, 2024
  • OK: $97.05 (physician, non-facility), effective Jul 1, 2026
  • TX: $81.76 (miscellaneous_other_professionals_portable_x_ray_radiologica, Miscellaneous Other Professionals - Portable X-Ray, Radiological Lab, Physiological Lab, non-facility), effective Sep 1, 2025
  • VA: $32.43 (medical, facility), effective Jul 1, 2026
  • VT: $167.66 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $238.34 (physician, facility), effective Jul 1, 2026
  • WY: $95.49 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.