A proposed rule published by the Centers for Medicare and Medicaid Services (CMS) recommends a decrease in Medicare payment for most sleep services for calendar year 2013 with the exception of home testing codes 95800 and 95801, which are expected to increase.
“The rule recommends a decrease in practice expense (PE) relative value units (RVUs) for most sleep services in 2013,” according to a report from the American Academy of Sleep Medicine. “As a result, overall payment for sleep services is recommended to decrease in most cases. However, for the unattended sleep testing codes 95800 and 95801, practice expense, and therefore overall payment, is expected to increase. The rule recommends that physician work and physician liability insurance (PLI) RVUs for all sleep services remain unchanged from the 2012 rates.”
After the proposed recommendations are reviewed and public comments are taken into consideration, a final rule will be published in November.
An AASM comparison of 2012 RVUs to 2013 proposed RVUs for sleep services can be viewed at the AASM Web site.