Billing and Coding: Polysomnography and Other Sleep Studies

Facility-based polysomnography (CPT 95808/95810/95811) is covered when performed in a sleep laboratory, while home sleep tests (G0398/G0399/G0400) are covered only when done with a comprehensive sleep evaluation in patients with a high pretest probability of moderate-to-severe obstructive sleep apnea. Documentation must include the physician order, device and training information for HSTs, detailed monitored parameters, and justification when testing exceeds expected frequency limits (generally ≤1 HST/year and ≤2 PSGs/year); MSLT (95805) is billed as a single unit covering all naps in one day.

"Polysomnography (CPT 95808, 95810, 95811) is covered when performed in a facility-based sleep study laboratory (not in the home or a mobile facility)."

Sign up to see full coverage criteria, indications, and limitations.