First Coast Service Options Inc, the local Medicare administrator for Jurisdiction 9, issued a Local Coverage Determination (LCD) for polysomnography and sleep testing. Jurisdiction 9 includes Florida, Puerto Rico, and the Virgin Islands.

A provision regarding accreditation of sleep labs is included in the LCD. According to the LCD, “The [sleep] center or laboratory must maintain documentation on file that indicates it is accredited by the American Academy of Sleep Medicine or that it is accredited as a sleep laboratory by the Joint Commission. This documentation must be available to Medicare on request.”

“Most of the hospital-based labs have used the blanket Joint Commission accreditation as being able to say that they are accredited. I think this policy makes that unacceptable,” says Marietta Bibbs, RPSGT, director of education at the Florida Sleep School and vice president and director of technical development at Sleep Management Centers LLC and Apnea Management Services LLC.

Alejandro Chediak, MD, of the Miami Sleep Disorders Center and past president of the AASM, echos Bibbs’ statement: “I agree with Marietta’s interpretation that the sleep center or laboratory must be either AASM accredited or accredited as a sleep laboratory by The Joint Commission,” he said.

Chediak also expressed frustration about the lack of responses from the sleep medicine community when the draft LCD was posted and open for comment. “As per usual protocol, the draft version of this LCD was presented at the contractor meeting in March and no one spoke out against the accreditation requirement. Just as it is with all other LCDs, the sleep studies LCD was then posted online for all to review and for comment,” says Chediak. “Based on the contractor’s responses to comments (available online at, it is reasonable to conclude that no one spoke out in opposition.”