Private Payer Communications
The AASM has sent many letters to private payers for Advocacy purposes over the years. Some communications are campaigns during which multiple payers are contacted about the same issue. Some of these include:
- Treatment with Positive Airway Pressure Therapy
- Alignment with the AASM Hypopnea Scoring Criteria
- Actigraphy reimbursement
- Accreditation
- Hypersomnia Treatment
Additional communications focus on specific member inquiries and/or concerns with payer policies. Some of the most recent communications are included below.
- Blue Shield of California – Diagnostic sleep testing using devices with one respiratory monitoring belt (5/8/2023)
- Beacon Health Options – Treatment of sleep disorders by psychologists (4/3/2023)
- TRICARE – Hypersomnia treatment policy (4/3/2023)
- CVS Caremark – Coverage of narcolepsy treatment (3/23/2023)
- BCBS of Mississippi – Accreditation policy exclusion (10/26/2022)
- Highmark BCBS of Western New York – Billing policy (9/12/2022)
- Aetna – Automatic Addition of 26 Modifier to 95806 (5/4/2022)
- Anthem BCBS Kentucky – Telehealth policy change (4/15/2022)
- United Healthcare – Medical Treatment Policy (9/17/2021)
- United Healthcare response (10/9/2021)
- United Healthcare – Support for APP Referrals (10/14/2020)
- United Healthcare response (1/13/2021)
We encourage members to send policies that do not align with AASM clinical practice guideline recommendations or accreditation standards to coding@aasm.org, for review.