Coding and Reimbursement

The AASM offers several tools to support members with matters of coding and reimbursement. Refer to the AASM’s resources to strengthen your operations.

Special Coding During COVID-19

The Centers for Medicare & Medicaid Services (CMS) has revised policies and regulations which allow for increased flexibility in providing safe and effective care during the COVID-19 pandemic. These temporary changes were made to promote the widespread use of telecommunications technology and avoid exposure risks to health care providers, patients, and the community during this outbreak. These regulations are applicable beginning March 1, 2020, lasting throughout the national public health emergency as declared by the secretary of Health and Human Services (HHS) and policy changes that may impact sleep medicine professionals are summarized on the AASM website. The American Medical Association also released Special Coding Advice During COVID-19 Public Health Emergency, for those treating COVID-19 patients. Additional guidance regarding telemedicine coding, including CMS resources can be found on the Telemedicine Codes page. AASM suggests members reach out to private payers for information regarding any changes to coding and billing requirements during the COVID-19 pandemic.

Payment Reform

Healthcare payment reform is complex. Two key drivers are the Medicare Access and CHIP Reauthorization Act (MACRA) and the AMA CPT and RUC processes. Use these pages to effectively understand changes to payment reform and how to integrate new measures into your sleep practice.

• The Merit-based Incentive Payment System (MIPS) program
• AMA Current Procedural Terminology (CPT) and RVS Update Committee (RUC)

Coding Support

These pages are designed to help members obtain answers to their most challenging coding-related questions. Resources are updated regularly to keep members informed of important trends in coding and reimbursement.

• Sleep Medicine Codes
• Telemedicine Codes
• Coding FAQs
• Other Coding Resources
• E/M Code Changes

Reimbursement Resources

The AASM provides resources to help members understand the reimbursement landscape. Access the Reimbursement Resources page for crucial background information about Medicare, Medicaid, and private payers, as well as tools for navigating current policies.

• Medicare Resources
  • Medicare Policies
• Guideline Scorecards
• Payer Advocacy
• Medicaid Resources

Practice Management News

Stay informed of key developments in sleep medicine reimbursement. Updates on areas such as the MACRA Quality Payment Program (QPP) and Medicare local coverage determinations are published on the Practice Management Newsfeed at the bottom of the Clinical Resources page.

Members can also receive timely responses to their coding-related questions by emailing coding@aasm.org.