In October 2019, both Blue Shield of CA (BSC) and Blue Cross Blue Shield Federal Employee Plan updated their policies to include WatchPATTM based on the PAT technology with oximetry and actigraphy as a covered home sleep apnea diagnostic test.  This inclusion of the WatchPAT technology follows an assessment of Diagnosis and Medical Management of Obstructive Sleep Apnea Syndrome recently released by Blue Cross Blue Shield Association (BCBS) Evidence Street.

Further to this, CMS recently published their final 2020 reimbursement rates for 95800 which is used for WatchPAT and those airflow devices that can measure sleep time and 95806 which is used for traditional airflow HSAT devices.  Below is a table that details the changes from 2019 and the new 2020 rates.

CPT Codes

Component

2020 Final Payment

% Change From 2019

95800

Global

$168.90

-2%

95800

TC

$126.32

-2%

95800

26

$42.59

-2%

95806

Global

$119.10

-15%

95806

TC

$72.90

-19%

95806

26

$46.20

-9%

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