Neurology Billing Services
Neurology billing services for practices that bill EEG, EMG and nerve conduction studies, botulinum toxin, sleep studies and infusions. BilNow codes the technical and professional split, tracks units and wastage, secures prior authorization and works denials so your neurology team stays with patients.
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Neurology Medical Billing
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No setup fee · No long-term contract · HIPAA-trained staff
Neurology Billing Services for Practices, EEG Labs and Infusion Suites
Neurology revenue comes from many service lines: visits, EEG, EMG and nerve conduction testing, botulinum toxin, sleep studies and infusions. Each has its own codes, split-billing rules and prior authorization trail. BilNow codes all of them to each payer’s rules, with HIPAA-trained staff working inside your EHR.
If your neurologists also treat pain, see our pain management billing page. Our medical credentialing services keep each neurologist and testing location enrolled with the payers that pay for your tests and infusions.
General and Subspecialty Neurology
Epilepsy, headache, movement disorder, MS and neuromuscular clinics.
EEG and Epilepsy Monitoring
Routine and long-term EEG, with the technical and professional split.
EMG and Nerve Conduction Labs
Study counts, add-ons and payer limits on repeat testing.
Headache and Botulinum Toxin Clinics
Chronic migraine injections, drug units and wastage.
Sleep and Infusion Services
Attended and home sleep studies, plus infusions that need prior authorization.
EEG Billing: CPT 95812–95830 and Long-Term Monitoring 95700–95726
| Code | Service |
|---|---|
| 95812 | EEG extended monitoring, 41–60 minutes |
| 95813 | EEG extended monitoring, 61–119 minutes |
| 95816 | EEG recorded awake and drowsy |
| 95819 | EEG recorded awake and asleep |
| 95822 | EEG recorded in coma or sleep only |
| 95824 | EEG for cerebral death evaluation only |
| 95829 | Electrocorticogram at surgery |
| 95830 | Sphenoidal electrode insertion by a physician or qualified professional |
When a lab and a reading neurologist bill separately, the lab reports modifier TC (equipment and technologist) and the neurologist reports modifier 26 (interpretation and report). The old all-night code 95827 was deleted in 2020.
Long-term EEG is split by code, not modifier
Do not add TC or 26 to long-term codes. 95700 covers setup, takedown and education, once per recording. Technologist codes 95705–95716 depend on length (2–12 or 12–26 hours), video and monitoring level (unmonitored, intermittent or continuous). Physician codes 95717–95726 depend on length and video: 95717–95720 are daily reports, and 95721–95726 are one summary report for the whole study, never billed together.
EMG and Nerve Conduction Studies: CPT 95907–95913, 95885–95887 and NCCI Pairs
Nerve conduction codes are chosen by the total number of studies in the session.
| Code | Service | Billing rule |
|---|---|---|
| 95907–95913 | Nerve conduction, by study count: 1–2, 3–4, 5–6, 7–8, 9–10, 11–12, 13+ | One code per session, all limbs combined |
| 95885 | Needle EMG, limited, per extremity with related paraspinals | Add-on to 95907–95913 |
| 95886 | Needle EMG, complete: 5+ muscles, 3+ nerves or 4+ spinal levels | Add-on; not with 95885 on one limb |
| 95887 | Needle EMG, non-extremity (cranial or axial) muscles | Add-on to 95907–95913 |
| 95860–95870 | Needle EMG without nerve conduction | Standalone; not with 95885–95887 |
Count each sensory study, each motor study (F-wave included) and each H-reflex as one study. NCCI does not allow EMG codes 95860–95872 for EMG used during biofeedback, unless the EMG is a separate medically necessary service, when modifier 59, XE or XS applies.
Payers cap studies by diagnosis, often with the AANEM recommended maximums, so a unilateral carpal tunnel work-up is expected to use fewer studies than a polyneuropathy work-up. Repeat testing is often covered only for new symptoms or a changed course. We match counts to the diagnosis and document findings nerve by nerve.
Botulinum Toxin for Chronic Migraine: CPT 64615, J0585 Units and JW or JZ Modifiers
CPT 64615 covers chemodenervation of the facial, trigeminal, cervical spinal and accessory nerve muscles, bilaterally, once per session. The drug is billed separately as J0585, onabotulinumtoxinA, per 1 unit. The labeled chronic migraine protocol is 155 units across 31 sites, repeated every 12 weeks.
Units given
Bill J0585 for the units injected, with a chronic migraine diagnosis (G43.7– or G43.E–) linked to the line.
Wastage with JW
Opening a 200-unit single-dose vial for a 155-unit dose is J0585 × 155, then J0585 × 45 with modifier JW on a second line.
No waste with JZ
When nothing is discarded from a single-dose vial, Medicare expects modifier JZ. Claims without the right modifier can be audited or rejected.
Coverage differs by payer. A Medicare policy updated in February 2026 and many health plans look for 15 or more headache days a month with at least 8 migraine days, a trial of preventive medicine and, for repeat sessions, a documented drop of at least 50% in migraine days. A same-day E/M needs modifier 25. Other conditions, such as cervical dystonia and spasticity, use other chemodenervation codes.
Sleep Studies: 95810 and 95811 vs Home Sleep Tests
Attended polysomnography is billed with 95810 (age 6 or older, sleep staging with four or more additional parameters, technologist attended), or 95811 when CPAP or bilevel therapy is started during the study. Unattended home tests use 95800, 95801 or 95806, and Medicare also uses G0398, G0399 and G0400 for type II, III and IV devices. Some plans accept the G-codes in place of CPT, so we check each one.
Medicare covers CPAP after a clinical evaluation and a positive attended study or type II, III or IV home test: an AHI or RDI of 15 or more, or 5–14 with symptoms or related conditions, followed by a 12-week trial. Sleep codes split with TC and 26. A sleep study and polysomnography cannot be billed for one encounter, and EEG is not billed with polysomnography unless a complete EEG is done at a separate encounter.
Infusion of Neurology Biologics: Units, Administration Codes and Prior Authorization
Ocrelizumab (J2350), natalizumab (J2323) and eptinezumab (J3032) each bill 1 mg per unit, and the natalizumab biosimilar has its own code, Q5134. Units must match the dose given plus any JW or JZ wastage.
Health plans commonly require prior authorization before the first dose, often with failed prior therapies, a preferred site of care and a renewal every 6 or 12 months. Hospital outpatient infusion is often allowed only with a documented reason. We request it through our prior authorization services before the patient is scheduled.
Administration coding is payer-specific: some Medicare contractors direct natalizumab to 96365–96376, and other plans differ. Only one initial administration code is billed per encounter unless drugs go through separate IV sites, and a same-day E/M needs modifier 25.
High-Complexity Neurology E/M Documentation and Telehealth Follow-Ups
Since 2021, office visits 99202–99205 and 99212–99215 are leveled by medical decision making (MDM) or total time. High complexity needs two of three elements.
Problems
A chronic illness with severe exacerbation, progression or treatment side effects, or one that threatens life or bodily function.
Data
Extensive: two of three categories, such as three items of note review, test review or test orders, independent test interpretation, or discussion with an outside physician.
Risk
High, such as drug therapy needing intensive monitoring for toxicity, or a decision about hospitalization.
By time, 99205 needs 60 minutes and 99215 needs 40, met or exceeded; Medicare’s prolonged code G2212 starts at 89 minutes for 99205 and 69 for 99215. Notes must show severity, data reviewed and time spent, or the level is downcoded.
Telehealth for follow-ups
Congress extended Medicare’s telehealth flexibilities, including the home as originating site and audio-only visits, through December 31, 2027. Follow-ups use E/M codes with place of service 10 for the home, modifier 93 for audio-only and modifier 95 where the payer requires it. Commercial plans differ on modifiers and place of service, so we check each policy. EEG, EMG, injections and infusions stay in person.
Common Neurology Billing Denials and How We Prevent Them
Most neurology denials come from a few causes. We catch them before the claim leaves, then work what comes back through our denial management services.
Medical necessity on EMG and NCS
Study counts above the payer limit for the diagnosis.
Bundled add-on codes
95886 without a qualifying 95907–95913, or with 95885 on one limb.
Botulinum toxin units and wastage
Missing JW or JZ, or units that do not match the vial.
Missing prior authorization
Infusions, injections and tests with no approval on file.
E/M downcodes and modifier 25
Time billed without documentation, or a same-day procedure without modifier 25.
Late filing and split-billing errors
Missed timely filing limits, or the wrong 26, TC or long-term EEG code.
How the work runs and what it costs
Intake and payer mapping
We list your services, payers, authorizations and EHR.
Coding and charge capture
Codes, units, modifiers and the technical and professional split.
Claim submission
Claims are checked against payer and NCCI edits before release.
Payments and denials
Posting, underpayments and denials worked to resolution.
BilNow charges 2.7% of collections, with no setup fee and no long-term contract, and supports more than 100 EHRs.
Neurology Billing FAQs
What does a neurology billing company do?
A neurology billing company handles eligibility, prior authorization, coding, claim submission, payment posting and denial follow-up for visits, EEG, EMG and nerve conduction studies, botulinum toxin, sleep studies and infusions. The work is code-specific: technical and professional splits, add-on codes, drug units and modifiers all decide payment. BilNow does this inside your existing EHR for the neurology services you provide.
How are routine and long-term EEGs billed?
Routine EEG codes such as 95816 and 95819 are split with modifier TC for the technical component and 26 for the interpretation. Long-term EEG uses separate codes instead: 95700 for setup, 95705–95716 for the technologist’s work and 95717–95726 for the physician’s review and report, with no TC or 26 modifier. The code depends on recording length, video and monitoring level.
How many nerve conduction studies can be billed?
Codes 95907–95913 are chosen by the total number of studies in the session, counting each sensory study, motor study (F-wave included) and H-reflex once. Payers limit the count by diagnosis, usually with the AANEM recommended maximums, and repeat testing needs a documented reason. Needle EMG is added with 95885–95887 only when nerve conduction is done the same day, once per extremity.
How is Botox for chronic migraine billed?
Bill CPT 64615 once per session and J0585 for each unit. A 155-unit dose from a 200-unit single-dose vial is J0585 × 155, plus a second J0585 line for the 45 discarded units with modifier JW. If nothing is discarded, Medicare expects modifier JZ. Link a chronic migraine diagnosis, and expect payers to ask for headache-day counts and prior preventive treatments.
Are sleep studies and home sleep tests billed differently?
Yes. Attended polysomnography is 95810, or 95811 when CPAP or bilevel therapy is started during the study. Unattended home tests use 95800, 95801 or 95806, and Medicare also uses G0398, G0399 and G0400 for type II, III and IV devices. Plans differ on which codes they accept and which test they approve first, so we check authorization rules before the study.
Do neurology infusions need prior authorization?
Health plans typically require approval before the first infusion of drugs such as ocrelizumab, natalizumab or eptinezumab. Requests usually include the diagnosis, failed prior therapies and the site of care, and approvals expire, so renewals must be tracked. Hospital outpatient infusion often needs a documented reason. We submit and track authorizations before scheduling, then bill the J-code in 1 mg units with wastage modifiers.
What documentation supports a high-complexity neurology visit?
Level 99205 or 99215 needs two of three high-complexity MDM elements: a severe or life-threatening problem, extensive data review or independent interpretation, and high-risk management such as intensive drug monitoring or a hospitalization decision. If you bill by time, record total time on the date of service: 60 minutes for 99205 and 40 for 99215. Telehealth follow-ups use the same E/M rules.
How much does neurology billing cost with BilNow?
BilNow charges 2.7% of collections. There is no setup fee and no long-term contract, so you pay when your claims get paid. Our HIPAA-trained staff work inside your existing billing system, and we support more than 100 EHRs. We start with a free review of your current neurology billing that covers authorizations, denial reasons, open A/R and where claims are slipping.
Prepared by the BilNow Editorial Team · Last updated October 2, 2026
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