Billing and Coding: Polysomnography and Other Sleep Studies

Coverage allows facility-based polysomnography (CPT 95808/95810/95811) performed in accredited sleep laboratories and home sleep testing (G0398/G0399/G0400) when done as part of a comprehensive sleep evaluation in patients with high pretest probability of moderate to severe OSA. Extensive documentation is required (device, monitored parameters, physician order, patient instruction, and physician qualifications), and utilization limits apply — generally no more than one HST per year and no more than two PSGs per year unless persuasive medical necessity is documented; MSLT (95805) is billed as one unit per single-day test.

"Home sleep test (HST; G0398, G0399, G0400) is covered when performed as part of a comprehensive sleep evaluation in patients with a high pretest probability of moderate to severe obstructive sleep ..."

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