Coding Articles
By the Coding and Reimbursement Advisory Committee Tonic motor activation (TOMAC), also known as bilateral peroneal nerve stimulation, is a therapeutic approach that delivers high-frequency electrical stimulation to the common peroneal nerves near the fibula in the lower legs. This stimulation activates the [...]
The American Academy of Sleep Medicine will submit comments in response to the Centers for Medicare & Medicaid Services (CMS) Physician Fee Schedule proposed rule specifically regarding the valuation of the new unattended sleep testing current procedural terminology (CPT) codes (95X18-95X23), which will [...]
DARIEN, IL — New Current Procedural Terminology codes for unattended sleep testing have been included by the Centers for Medicare and Medicaid Services in the Medicare physician fee schedule proposed rule, which CMS posted online yesterday. The updated CPT code set, which the [...]
By the Coding and Reimbursement Advisory Committee As access pressures increase and value-based care models expand, interprofessional electronic consultations (e-consults) have become an important tool for sleep physicians. When properly structured and documented, e-consults allow specialists to provide timely expertise without requiring a face-to-face [...]
By the Coding and Reimbursement Advisory Committee Electronic physician visits, commonly called e-visits, are an increasingly important part of modern health care delivery. Unlike scheduled telehealth video appointments or quick virtual check-ins, e-visits use a structured, asynchronous digital platform to facilitate communication between [...]
After advocacy efforts by the American Academy of Sleep Medicine and other medical organizations, UnitedHealthcare has announced a delay in implementing its remote patient monitoring policy. The AASM recently submitted a letter to UnitedHealthcare opposing its new remote patient monitoring policy and the [...]
By the Coding and Reimbursement Advisory Committee Cognitive behavioral therapy for insomnia (CBT-I) is the first-line, evidence-based treatment for chronic insomnia. Unlike pharmacological approaches, CBT-I focuses on identifying and modifying the thoughts and behaviors that perpetuate sleep difficulties. It has been shown to [...]
The Centers for Medicare & Medicaid Services finalized the 2026 Quality Payment Program final rule on Nov. 5, 2025, introducing updates to the quality, cost, improvement activities, and Merit-based Incentive Payment System value pathways (MVP) categories. This rule also includes details on future [...]
Following the implementation of downcoding policies by two major private payers, Aetna and Cigna, effective Oct. 1, 2025, AASM analyzed payer trends and identified additional health plans with active or proposed downcoding programs targeting higher-level evaluation and management (E/M) services. These include Ambetter [...]
UnitedHealthcare has announced plans to significantly narrow coverage for remote patient monitoring services across both its Medicare Advantage and commercial plans, effective Jan. 1, 2026. Under the revised policy, remote patient monitoring will be considered reasonable and necessary only for patients with heart [...]