According to my Pennsylvania Locality 99 issue of the January 2011 Medicare Physician's Fee Schedule it would appear that unattended studies are being reimbursed at a higher rate than lab-based PSG's. Can anyone help explain this?
According to Sleep Review Magazine there are 2 new codes for 2011:
CPT Code 95800 is "sleep study unattended, simultaneous recording, heart rate, oxygen saturation, respiratory analysis (eg by airflow or peripheral arterial tone), and sleep time." while
CPT Code 95801 is similar, but without sleep time: "sleep study unattended, minimum of heart rate, oxygen saturation and respiratory analysis (eg by airflow or peripheral arterial tone)."
When looking at my 2011 Fee Schedule procedure code G0400 (Type IV HST) has a PAR FEE of $145.73. Procedure code 95810 (lab-based sleep study) has a PAR FEE of $504.27. Yet, the new unattended sleep study 95800 has a PAR FEE of $945.05 and the 95801 has a PAR FEE of $1,599.28.
This doesn't make any sense. I must be misinterpreting this information somehow.
Please help.
According to Sleep Review Magazine there are 2 new codes for 2011:
CPT Code 95800 is "sleep study unattended, simultaneous recording, heart rate, oxygen saturation, respiratory analysis (eg by airflow or peripheral arterial tone), and sleep time." while
CPT Code 95801 is similar, but without sleep time: "sleep study unattended, minimum of heart rate, oxygen saturation and respiratory analysis (eg by airflow or peripheral arterial tone)."
When looking at my 2011 Fee Schedule procedure code G0400 (Type IV HST) has a PAR FEE of $145.73. Procedure code 95810 (lab-based sleep study) has a PAR FEE of $504.27. Yet, the new unattended sleep study 95800 has a PAR FEE of $945.05 and the 95801 has a PAR FEE of $1,599.28.
This doesn't make any sense. I must be misinterpreting this information somehow.
Please help.