What are the codes for home sleep testing and what are the payment rates?
CMS, in conjunction with medical literature, established the usefulness of unattended portable PSG in the home within defined parameters. The three G-codes provide specificity to the site of service for the unattended sleep study performed in a patient’s home. CMS has assigned unattended studies 95806, G0398, and G0399 billed by the OPPS hospital into APC grouping 5721, with a payment rate of $145.43. For 2023, CMS has assigned G0400 to APC 5722 with a payment rate of $280.06.
This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.