What are the Medicare guidelines for the use of home-based, limited-channel polysomnography (PSG)?

Updated: Apr 29, 2020
  • Author: Carmel Armon, MD, MSc, MHS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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In 2008, Medicare approved the use of unattended home sleep monitoring devices of types II, III, or IV (with at least 3 channels) if the patient received a complete clinical evaluation and does not have atypical or complicated symptoms and the studies were read by a trained sleep specialist. [2, 3] The guidelines for using a portable monitor unattended home sleep study device for continuous positive airway pressure (CPAP) therapy include the following:

  • Type II device: This type of device has a minimum of 7 channels (eg, EEG, EOG, EMG, ECG-heart rate, airflow, respiratory effort, oxygen saturation). This type of device monitors sleep staging so the apnea-plus-hypopnea index (AHI) can be calculated.

  • Type III device: This device has a minimum of 4 channels, including ventilation or airflow (at least 2 channels of respiratory movement or airflow), heart rate or ECG, and oxygen saturation.

  • Type IV device: This type of device does not meet requirements for other types, and many measure only 1-2 parameters (eg, oxygen saturation or airflow). For Medicare reimbursement, these devices, including WatchPAT (Itamar Medical Ltd, Caesarea, Israel) can be used if they have a minimum of 3 channels.

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