Question:

What codes represent unattended sleep studies performed at a patient’s home and what would be their APCs?

Answer:

Recently, 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 were billed by the OPPS hospital into APC grouping 5721, with a payment rate of $142.59. For 2022, CMS has assigned G0400 to APC 5722 with a payment rate of $270.29.

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