The Health Plan Sleep CPT Code List | The Health Plan

The Health Plan Sleep CPT Code List

The Health Plan · PayerPolicy · EVICORE-HPLAN-THE_HEALTH_PLAN-424028EDD246

Status: Active
Effective: January 1, 2026
Last reviewed by The Health Plan: January 1, 2026
Last checked by Backwork: October 1, 2026

Summary of the payer’s published policy. Not a coverage determination — confirm with The Health Plan before submitting.

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Codes in this policy

Each code’s status is what the policy records for it. This page does not show the policy’s criteria. Read them in the payer’s source.

Codes this policy lists and each code’s status in the policy
Code	Code system	Status in this policy
95782	CPT	Prior auth required
95783	CPT	Prior auth required
95805	CPT	Prior auth required
95807	CPT	Prior auth required
95808	CPT	Prior auth required
95810	CPT	Prior auth required
95811	CPT	Prior auth required
E0470	HCPCS	Prior auth required
E0471	HCPCS	Prior auth required
E0485	HCPCS	Prior auth required
E0486	HCPCS	Prior auth required
E0492	HCPCS	Prior auth required
E0493	HCPCS	Prior auth required
E0561	HCPCS	Prior auth required
E0562	HCPCS	Prior auth required