Eight new sleep apnea payer policy scorecards are now available

The AASM Payer Policy Review Committee recently developed new scorecards for eight payer policies, focusing on diagnostic testing for obstructive sleep apnea (OSA) in adults. The committee evaluated the insurers’ policies and assigned a score based on nine criteria, aligned with the AASM’s Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Apnea.

Payers whose policies were reviewed are:

1. Humana
2. Blue Cross Blue Shield of Massachusetts
3. Cigna
4. Blue Cross Blue Shield Highmark Pennsylvania
5. Independence Blue
6. Blue Cross Blue Shield of Florida
7. CareFirst Blue Cross Blue Shield
8. eviCore (revised policy)

AASM scorecards are created to evaluate how effective payer policies are at establishing appropriate coverage for diagnostic sleep testing services and to encourage insurers to adopt evidence-based policies that support patient safety and delivery of high-quality care.

Policy scorecards for 10 payers currently are available for review and download on the Private Payers page of the AASM website. AASM members can send payer policy-related questions to coding@aasm.org.