Question: Can we bill for telemedicine services in sleep medicine (consults, follow-up encounters)? What is the code for that? Answer: Coverage of telemedicine services is payer specific. Providers should contact private payers directly for information regarding coverage of telemedicine services. Medicare covers services [...]

In the 2019 Hospital Outpatient Prospective Payment System (HOPPS) Final Rule, the Centers for Medicare & Medicaid Services (CMS) capped payment for clinic visits provided in all off-campus provider-based departments (PBDs) at a rate equivalent to the Physician Fee Schedule (PFS). Given the 22% [...]

The AASM has partnered with Premier, Inc, to provide the MIPSwizard, an online tool that helps eligible clinicians participate in the Merit-based Incentive Payment System (MIPS) by reporting for the 2018 calendar year. The tool allows eligible clinicians to rapidly collect, validate and submit [...]

In a Nov. 8 announcement, the Centers for Medicare and Medicaid Services (CMS) released data summarizing the year one payment adjustment results and highlighting the overall success of the Quality Payment Program (QPP). In year one, more than one million clinicians who were [...]

In order to provide payers with a resource to help align their policies with evidence-based guidance, the AASM Payer Policy Review Committee (PPRC) recently finalized a Template Policy on Diagnostic Testing for Obstructive Sleep Apnea. This template policy gives payers an example that agrees [...]

Due to communication between the AASM Payer Policy Review Committee (PPRC) and representatives from Blue Cross Blue Shield and Blue Care Network of Michigan, the payer has updated its policy and now accepts the AASM RECOMMENDED hypopnea scoring criteria. The PPRC has been communicating [...]

Despite the submission of AASM comments urging the Centers for Medicare & Medicaid Services (CMS) to retain all four of the AASM-stewarded sleep apnea measures in the Merit-based Incentive Payment System (MIPS), CMS finalized the removal of two measures for the 2019 reporting year and [...]