Digital EEG Spike Analysis
Defines medical necessity and coding requirements for digital EEG spike analysis (CPT 95957) for Centene-affiliated health plans, specifying when the service is covered and for whom.
Noted in criteria statements I and II that code in question is 95957.
Removed video EEG codes from Table 1 and added them to the label for Table 1, specifying that 95957 is medically necessary when billed in conjunction with a video EEG code and a diagnosis code in Table 2.
In the coding description for 95957, added a note that it is performed in conjunction with any of the CPT codes listed (95718, 95720, 95722, 95724, 95726).
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.