In a recent email from staff at the Centers for Medicare & Medicaid Services (CMS), the AASM was notified that the specialty code for sleep medicine will be implemented in May.
As the AASM previously announced, CMS approved a specialty code for sleep medicine in Jan 2011. The implementation of the code, originally projected for Oct. 2011, was delayed last fall and scheduled to be implemented this month. CMS staff has indicated that the new code will be available via the Medicare Provider Enrollment, Chain and Ownership System (PECOS) in May. The paper enrollment form will be updated to include the new specialty code this October. Also in October, CMS will publish a Medicare Learning Network (MLN) article about the new code. The AASM will alert the membership of this article as soon as it is published.
Establishing a physician specialty code for sleep medicine has a number of benefits for the field:
• The specialty code will enable more accurate identification of Medicare Physician fee Schedule (MPFS) practice expenses related to sleep medicine services.
• The specialty code will assist CMS in its peer-to-peer comparison of services from specific specialties and in claims adjudication.
• The specialty code will provide a more effective means of identifying episodes of care provided for patients with chronic sleep disorders, especially obstructive sleep apnea (OSA).
The AASM will provide members with additional details on the code implementation as they become available.