Until the dawn of the modern era (18th Century), diagnosis and treatment of brain disorders were a stuff of graphic nightmares. Thankfully, the pioneering physiologists have come up with the objective means of determining brain abnormalities. Treating neurological disorders primarily rely on the method of interpreting the calculable electrical brain wave variability.
Prior to the development of standard electroencephalography (EEG) by the German psychiatrist Hans Berger, dealing with mental disorders was highly problematic. In fact, epilepsy was a disease that was rife with violations of fundamental human rights. It was only during the 1970’s when America and Great Britain amended laws that discriminate against epileptic individuals.
According to the World Health Organization, roughly 50 million people around the world are currently suffering from epilepsy – with a ratio estimating 7 out of 14 within a population of 1000. EEG remains as the gold standard diagnostic procedure not only for epilepsy but other non-communicable neurological illnesses including (but not limited to) stroke, sleep disorders, brain injury, and dementia.
About Transparency of Medical Costs
Healthcare is one of the most contentious discussions in the United States, and the most prevalent point of dispute concerns medical bill transparency. Traditionally, the cost of specific services is rarely divulged in public. Apart from contributing national budget deficit, the lack of transparency also causes general cynicism among average consumers.
EEG test cost is just among the many procedures that are seldom disclosed in the open references of hospitals and clinics. Thankfully, several online resources empower consumers and give them a relative degree of confidence in terms of dealing with the nuances of health care expenses.
Out of Pocket EEG Estimates
As mentioned earlier, a few online sources allow American consumers experience a degree of transparency in terms healthcare prices. So, how much does an EEG test cost if a patient does not have any health insurance? The following references provide their own ball park figures:
National price range: $550 to $858
- Initial check-up: $181 to $274
- EEG procedure: $279 to $452
- Follow-up check-up: $90 to $132
Mayo Clinic Estimate
- Rochester (Minnesota) campus: $874
- Phoenix or Scottsdale (Arizona) campus: $972
- Jacksonville (Florida) campus: $1,073
Other Transparent Hospitals
- St Peter’s Hospital (Helena, Montana)
- EEG Awake and Drowsy: $802.66
- EEG 24 Hours: $1,615.98
- EEG Awake and Asleep: $633.20
- St. Elizabeth’s Hospital (Washington, D.C)
- EEG Awake and Drowsy: $925
- EEG 41-60 Minutes: $1,248
- EEG Awake and Asleep: $328.23
- EEG Digital Analysis: $342
Medicare Physician Fee Schedule
Consider the out-of-pocket cost featured previously, how much does an EEG test cost for the insured patients? The government-issued Medicare seems to be a fitting example of a transparent insurance provider. As of 2018, the diagnostic cost in the neurology department has not changed since the previous year.
Prior to discussing the details of Medicare costs, it is important for every consumer to familiarize oneself with the CPT (Current Procedural Terminology) codes. Each CPT is also categorized according to its two important modifiers:
- “26” pertains to a procedure that only charges the “professional component.”
- “TC” pertains to a procedure that only charges the “technical component.”
In a specific context, the hospital may categorize the CPT as 26 if the patient only avails the physician’s interpretation of results, especially those that are acquired from another provider. Similarly, the hospital may categorize the CPT as TC if the bill does not include the services of the medical professional. These are the following examples of progressive EEG tests and their corresponding nationwide costs presented in the latest fee schedule by Medicare:
EEG awake and drowsy
CPT Code: 95816
- Overall: $365.44
- TC: $306.69
- 26: $58.67
EEG awake and asleep
CPT Code: 95819
- Overall: $418.11
- TC: $359.35
- 26: $58.76
Ambulatory EEG monitoring
CPT Code: 95950
- Overall: $333.92
- TC: $252.59
- 26: $81.33
MD Save Consumer Option
It is possible to pay a relatively cheaper median EEG test cost for patients who did not avail medical insurance. Sources like MD Save offer consumers discounted rates in several selected locations. The average nationwide cost for ‘EEG awake and asleep’ is anywhere between $336 and $467. It is important to take note of the following states and their MD Save providers:
- Bayfront Health Neurology Center (Port Charlotte)
- Bayfront Health Neurology Center (Punta Gorda)
- Dr. Amy Mellor (Port Charlotte)
- Dr. Saeed Shahzad (Punta Gorda)
- Galesburg Cottage Hospital Neurology (Galesburg)
- Dr. Elizabeth Sullivan (Hattiesburg)
- Dr. Kathleen Messenger (Hattiesburg)
EEG Procedures Overseas
One of the most cost-efficient alternatives for expensive healthcare services that American consumers exploit is ‘medical tourism.’ Globalization has allowed developing countries to catch up with the standards of First World nations. Modern medicine is just one of the many fields wherein mutual cooperation for excellence is not hindered by geographical boundaries.
Accreditation agencies such as the International Organization for Standardization (ISO), the Joint Commission International (JCI), the Blue Cross Blue Shield Association (BCBSA), and the Council for Health Service Accreditation of South Africa (COHSASA) help maintain world class healthcare standards at a price matching the nation’s developing economy. So, how much does an EEG test cost abroad? These are the following hospitals outside the United States charging less than the national average cost for EEG, according to Medigo:
European Medical Center
EEG test cost: from $321
Hisar Intercontinental Hospital
EEG test cost: from $238
Herzliya Medical Center
EEG test cost: from 651
International Hospital Center of Tunisia
EEG test cost: from $50
- If you have a Medicare part B and part C insurance policy, it can cover for an electroencephalogram (EEG) test. Medicare part B will pay the full approved Medicare cost for an encephalogram (EEG) test done in a hospital outpatient department or 80 percent of the approved Medicare cost for an encephalogram (EEG) test done in an another setting. However, the EEG test must be requested as a medically necessary procedure and performed by a licensed health care professional who participates in Medicare. Medicare Payment and Reimbursement provides CPT codes of different EEG, its description, and average fee, check out their website for more information about Medicare and EEG test.
- Most insurance companies only cover for a medically necessary procedure but when can the procedure be deemed as “medically necessary”? Medically necessary is defined by Medicare as “health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.” You can ask your health care provider about this for more information.
- Fortunately, there is no risk involved with an EEG test. The test is safe and painless. There are cases of epileptic individuals whose seizures are triggered by the flashing light of the machine. However, technicians operating the test are well-trained to handle situations like this.
- Before an EEG examination, you must wash you’re the night before and do not apply hair conditioning or shampoo products on the day of the test. You must also avoid eating or drinking food and beverages that contain caffeine for about eight (8) hours before the electroencephalogram procedure. Also, seek advice from your health care provider such as whether there are medications you should quit taking.
- What usually happens during an EEG? Foremost, the operator or technician will size your head and then attaches electrodes (flat metal disc) on your scalp using a distinct adhesive. Once the electrodes are in place, the EEG test will begin and usually take forty (40) to sixty (60) minutes. A video is typically recorded during the electroencephalogram (EEG) test.
- Side effects will not be from the actual electroencephalogram (EEG) test but rather to the medication or sedation given by the doctor before the test.