Medicare implemented a specialty code for sleep medicine in 2012. However, claims data shows that the sleep medicine specialty code is only rarely used by providers of sleep medicine services. The sleep field is therefore not experiencing the benefits of having our own specialty code in the Medicare system. If it is used, the sleep medicine specialty code is expected to have the following benefits:
- Enable more accurate identification of Medicare Physician Fee Schedule practice expenses related to sleep medicine services.
- Assist CMS in its peer-to-peer comparison of services from specific specialties and in claims adjudication.
- Provide a more effective means of identifying episodes of care provided to patients with chronic sleep disorders.
If your practice is at least 50 percent sleep, the AASM encourages you to make sleep medicine your primary specialty in the Medicare provider enrollment system. Providers can review their current primary specialty and make any necessary changes using the Medicare PECOS website. Medicare has developed a step-by-step guide with detailed instructions for specialty changes.