New scorecards for sleep apnea diagnostic testing policies now available

The AASM Payer Policy Review Committee recently developed new scorecards for five 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.

Policies from these payers were reviewed:

1. Blue Cross Blue Shield and Blue Care Network of Michigan
2. Harvard Pilgrim
3. Premera Blue Cross
4. Priority Health
5. Excellus Blue Cross Blue Shield

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 nearly 20 payers 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.