CIGNA and National Heritage Insurance Corporation (NHIC), local Medicare carriers, announced individual valuations for the technical component and the modifier 26 for the following G-codes: G0398, G0399 and G0400, according to information from the American Academy of Sleep Medicine (AASM).
The individual valuations for these codes are available through the AASM.
“These reimbursements are on par with what we have seen from other carriers,” says Landon Pendleton, director of product development, Instant Diagnostic Systems (IDS), a company specializing in home sleep testing. “We see very few sleep professionals or facilities making the investment in equipment, staff, and training for such a low reimbursement. Most [sleep professionals] we have spoken with will attempt to steer patients to the full in-lab PSG, but when patients demand HST, the referral would be redirected to a nationwide ‘niche’ provider like IDS.”
Edits to HCPCS codes G0398-G0400 were included in the October Update to the 2008 Medicare Physician Fee Schedule Database. G0398-G0400 were edited to allow  -26 and -TC modifiers. Besides this allowance, PC/TCs were changed from 0 to 1. The modifications allow home sleep tests to be split into professional and technical components.
“CPT modifier -26 represents the professional interpretation of the home sleep test,” Pendleton explains. “Typically, this modifier will be used by a facility that is billing for a home sleep test where the interpretation or reading of the report has been outsourced to a qualified physician (boarded sleep physician in this case) not employed by the facility, and thus should be reported separately from the technical component. Alternatively, a sleep physician might bill -26 for their own practice in a similar situation, but where the facility does not bill for the interpretation.” The distinction is that in the first case, the facility pays the doctor for the interpretation, and the facility bills both the TC AND the 26. In the second case, the facility has a nonemployed physician performing the interpretation, but they are not paying for it (purchasing it). The facility bills TC and the physician is billing for 26. 
In explaining the TC modifier, Pendleton says, “The TC modifier is the technical component of the test and is to be billed by the qualified facility that bears the expense of owning, operating, and processing the test equipment, and related supplies.”
CIGNA policy covers Idaho, North Carolina, and Tennessee. The NHIC policy covers Maine, Massachusetts, New Hampshire, and Vermont.