Information on Sleep Medicine Codes 95800 and 95801

Published in the 2011 Physician Fee Schedule is information on payment for sleep medicine codes, including national values for physician work, practice expense and professional liability insurance RVUs. The new values for the RVUs are effective January 1, 2011. The AASM has prepared a table that reflects RVU values for sleep medicine codes and the total national payment.

Also included in the Physician Fee Schedule are RVU values for two new codes: 95800 and 95801. Full descriptors of the codes can be found in the 2011 CPT code book, which is published by the American Medical Association (AMA); material published in the book is protected under copyright law. CPT code 95800 is published as Sleep study, unattended and CPT code 95801 is published as Sleep study, unattended with respiratory analysis. These two codes replace T codes 0203T and 0204T.

In the 2011 Physician Fee Schedule, the total RVUs listed for codes 95800 and 95801 are higher than the total RVUs for 95810. The AMA contacted the AASM on behalf of CMS with a request for additional practice expense information for codes 95800 and 95801, which we have provided. CMS may be looking for this additional information in order to correct a potential error in their calculations for those codes. Please note that these values may not be final and corrections may be addressed in a separate corrections document published by CMS at a later date.

2010-12-09T00:00:00+00:00 December 9th, 2010|Clinical Resources|