Question:
What are the codes for home sleep testing and what are the payment rates?
Answer:
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.