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					Portable Monitoring Coverage



Physician Qualifications



Sleep Technologist Qualifications

Patient Compliance with CPAP

Accreditation of Center

MSLT Requirements




Direct/General Supervision Requirements
                                            Virginia
                             TrailBlazer Health Enterprises
                                         Link to TrailBlazer LCD

"Unattended portable sleep studies (95806) are not indicated for the routine assessment of
obstructive sleep apnea or other sleep disorders. When trained personnel are not physically present
throughout a recording session (data observation via modem link is still considered “unattended”), the
polysomnogram is considered “unattended” and is not covered by Medicare."



"A physician or doctoral level professional with satisfactory training in sleep medicine and significant
experience in interpretation of standard polysomnograms must interpret these recordings."

"Sleep studies performed without a qualified technologist in attendance throughout the duration of the
test are neither sufficiently sensitive nor specific enough to assist with diagnosis, and therefore, are
not covered by Medicare."

                                             Not addressed


                                             Not addressed


                                             Not addressed



"Diagnostic testing routinely performed in sleep disorder clinics may be covered even in the absence
of direct supervision by a physician."

"Therapeutic services may be covered in a hospital outpatient setting or in a freestanding facility. This
is provided they meet pertinent requirements for the particular type of services, are reasonable and
necessary for the patient and are performed under the direct personal supervision of a physician."