Trailblazer Issues G-Code Reimbursement Rates for Portable Monitoring

Trailblazer, the regional Medicare carrier with the responsibility for processing all Part A and Part B fee-for-service (traditional) Medicare claims in Colorado, Oklahoma, New Mexico and Texas, has issued the valuation, or payment amounts, it will recognize for the home monitoring G-Codes. The following codes, with the related valuations, identify scenarios where Medicare provides coverage for beneficiaries who utilize portable monitoring to assist in the diagnosis of obstructive sleep apnea (OSA):

G0398: Home Sleep Testing, Type II portable monitor; minimum 7 channels – $150.00
     – $100 is recognized for the Professional Component
     – $50 is recognized for the Technical Component

G0399: Home Sleep Testing, Type III portable monitor; minimum 4 channels – $125.00
     – $85 is recognized for the Professional Component
     – $35 is recognized for the Technical Component

G0400: Home Sleep Testing, Type IV portable monitor; minimum 3 channels – $100.00
     – $70 is recognized for the Professional Component
     – $30 is recognized for the Technical Component

Trailblazer is the first Medicare carrier to attach valuations to these codes. As other carriers take similar actions in the near future, the American Academy of Sleep Medicine will forward this information to the membership.

2008-09-12T00:00:00+00:00 September 12th, 2008|Professional Development|