Does G0399 require prior authorization?

No, G0399 does not require prior authorization (high confidence). Code is covered without prior authorization.

What is the Medicare reimbursement rate for G0399?

Medicare facility rate: N/A. Non-facility rate: N/A. Work RVU: 0.00.

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`G0399`, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Sleep study reports must document parameters monitored and the study start time and duration (day/night).
Reports must include total sleep time, sleep efficiency, and number and duration of awakenings.
For tests with sleep staging, the report must state the time and percent time spent in each sleep stage.
For tests monitoring sleep latency or maintenance of wakefulness (MSLT/MWT), reports must include latency to NREM and REM, individual sub-test latencies, mean sleep latency, and number of REM occurrences on MSLT.
Reports must describe respiratory patterns including type (central/obstructive/periodic), number and duration of events, effect on oxygenation, sleep-stage and body-position relationships, and responses to diagnostic/therapeutic maneuvers.
Reports must document cardiac rate/rhythm and any effects of sleep-disordered breathing on the ECG.

Key Coverage Criteria

Polysomnography and sleep studies are covered for the diagnostic evaluation of suspected sleep disorders (including obstructive sleep apnea) and for assessment of response to therapies (e.g., CPAP) when performed with physician review, interpretation, and report.
Studies that include sleep staging (polysomnography) are covered when they meet the policy's recording and documentation requirements.
Diagnostic polysomnography or other sleep testing is covered when the patient has symptoms or complaints of one of the conditions listed in LCD L36839.
A single polysomnogram (PSG) with EEG is ordinarily sufficient and covered to evaluate and diagnose suspected obstructive sleep apnea (OSA).
Diagnosis of narcolepsy is ordinarily confirmed by up to three Multiple Sleep Latency Test (MSLT) naps; MSLT (CPT 95805) performed appropriately is covered for this indication.
Outpatient sleep studies that meet the reasonable and necessary clinical criteria in Novitas LCD L35050 are covered.

20 Active Policies

CGS-J15-L36902, Polysomnography and Other Sleep Studies

J15

CGS-J18-L36902, Polysomnography and Other Sleep Studies

J18

WPS-J5-L36839, Polysomnography and Other Sleep Studies

A56903, Billing and Coding: Polysomnography and Other Sleep Studies

WPS-J5-L38528, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

A53019, Polysomnography and Sleep Studies Medical Policy Article

WPS-J8-L38528, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

WPS-J8-L36839, Polysomnography and Other Sleep Studies

FIRST_COAST-L33405, Polysomnography and Sleep Testing

A57496, Billing and Coding: Polysomnography and Sleep Testing

NORIDIAN-JE-L36861, Polysomnography and Other Sleep Studies

NORIDIAN-JF-L36861, Polysomnography and Other Sleep Studies

NOVITAS-JH-L35050, Outpatient Sleep Studies

PALMETTO-JJ-L36593, Polysomnography

A56923, Billing and Coding: Outpatient Sleep Studies

NOVITAS-JL-L35050, Outpatient Sleep Studies

PALMETTO-JM-L36593, Polysomnography

CARELON-sleep-disorder-management-2025-11-15-updated-2026-07-01, Sleep Disorder Management

A56995, Billing and Coding: Polysomnography

A57049, Billing and Coding: Polysomnography and Other Sleep Studies

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about G0399 Sign up free

G0399, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

HCPCS/CPT

Prior Authorization

No Prior Auth Required

Code is covered without prior authorization (high confidence)

Medicare Pricing

Work RVU

0.00

Facility

N/A

Non-Facility

N/A

Documentation Required

Sleep study reports must document parameters monitored and the study start time and duration (day/night).
Reports must include total sleep time, sleep efficiency, and number and duration of awakenings.
For tests with sleep staging, the report must state the time and percent time spent in each sleep stage.
For tests monitoring sleep latency or maintenance of wakefulness (MSLT/MWT), reports must include latency to NREM and REM, individual sub-test latencies, mean sleep latency, and number of REM occurrences on MSLT.
Reports must describe respiratory patterns including type (central/obstructive/periodic), number and duration of events, effect on oxygenation, sleep-stage and body-position relationships, and responses to diagnostic/therapeutic maneuvers.
Reports must document cardiac rate/rhythm and any effects of sleep-disordered breathing on the ECG.

Key Coverage Criteria

Polysomnography and sleep studies are covered for the diagnostic evaluation of suspected sleep disorders (including obstructive sleep apnea) and for assessment of response to therapies (e.g., CPAP) when performed with physician review, interpretation, and report.
Studies that include sleep staging (polysomnography) are covered when they meet the policy's recording and documentation requirements.
Diagnostic polysomnography or other sleep testing is covered when the patient has symptoms or complaints of one of the conditions listed in LCD L36839.
A single polysomnogram (PSG) with EEG is ordinarily sufficient and covered to evaluate and diagnose suspected obstructive sleep apnea (OSA).
Diagnosis of narcolepsy is ordinarily confirmed by up to three Multiple Sleep Latency Test (MSLT) naps; MSLT (CPT 95805) performed appropriately is covered for this indication.
Outpatient sleep studies that meet the reasonable and necessary clinical criteria in Novitas LCD L35050 are covered.

20 Active Policies

CGS-J15-L36902, Polysomnography and Other Sleep Studies

J15

CGS-J18-L36902, Polysomnography and Other Sleep Studies

J18

WPS-J5-L36839, Polysomnography and Other Sleep Studies

A56903, Billing and Coding: Polysomnography and Other Sleep Studies

WPS-J5-L38528, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

A53019, Polysomnography and Sleep Studies Medical Policy Article

WPS-J8-L38528, Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

WPS-J8-L36839, Polysomnography and Other Sleep Studies

FIRST_COAST-L33405, Polysomnography and Sleep Testing

A57496, Billing and Coding: Polysomnography and Sleep Testing

NORIDIAN-JE-L36861, Polysomnography and Other Sleep Studies

NORIDIAN-JF-L36861, Polysomnography and Other Sleep Studies

NOVITAS-JH-L35050, Outpatient Sleep Studies

PALMETTO-JJ-L36593, Polysomnography

A56923, Billing and Coding: Outpatient Sleep Studies

NOVITAS-JL-L35050, Outpatient Sleep Studies

PALMETTO-JM-L36593, Polysomnography

CARELON-sleep-disorder-management-2025-11-15-updated-2026-07-01, Sleep Disorder Management

A56995, Billing and Coding: Polysomnography

A57049, Billing and Coding: Polysomnography and Other Sleep Studies

Have a follow-up question?

Ask Backwork about documentation requirements, denial risks, or coverage in your state.

Ask Backwork about G0399 Sign up free

`G0399`, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G0399`, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G0399, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

G0399, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

Prior Authorization

Medicare Pricing

Documentation Required

Key Coverage Criteria

20 Active Policies

Related Codes

Have a follow-up question?

`G0399`, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4

`G0399`, Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4