Polysomnography and Other Sleep Studies

Medicare covers polysomnography and other categorized sleep tests primarily to diagnose obstructive sleep apnea (using Type I–IV devices and specified criteria), to evaluate narcolepsy (overnight PSG followed by MSLT), and for selected parasomnias when seizure disorders are excluded. Home sleep testing is covered only for patients with a high pretest probability of moderate-to-severe OSA and qualified physicians, while multiple exclusions apply (e.g., chronic insomnia, circadian rhythm disorders, certain comorbidities for home testing); physician/technician credentials and facility accreditation and documentation are required and repeat tests generally require persuasive medical justification.

"Type I attended facility-based polysomnography (PSG) is covered to aid diagnosis of obstructive sleep apnea (OSA) in beneficiaries with clinical signs or symptoms indicative of OSA when performed a..."