Payer PolicyActive
Acoustic Pharyngometers and SNAP Testing System
AETNA-CPB-0336
Aetna
Effective: May 2, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna covers the SNAP Testing system (HCPCS G0400, home sleep test type IV) with a minimum of 3 channels for adults only when the CPB 0004 obstructive sleep apnea in adults selection criteria are met; versions with fewer than 3 channels and acoustic pharyngometry (e.g., Eccovision) are considered experimental/investigational and not covered for screening, diagnosis, treatment planning, or predicting surgical success.
Coverage Criteria Preview
Key requirements from the full policy
"ICD-10 codes covered if selection criteria are met (SNAP Testing system using 3 or more channels): F51."
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