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February 2017

More clarification: Requirements for sleep testing

In a recent publication of the medical policy for sleep testing, we omitted some essential requirements. To clarify, the requirements are as follows:

  • In order to perform and get reimbursed for in-center or out-of-center sleep testing, a doctor must be board-certified in sleep medicine by the American Board of Medical Specialties or the American Board of Sleep Medicine.
  • Any M.D. or D.O. may prescribe a sleep test as long as it’s performed and interpreted by a doctor who is board-certified in sleep medicine.
  • Follow our prior authorization program for in-lab sleep testing. To obtain an authorization you must be board-certified.

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