Anthem Blue Cross and Blue Shield has released its policy on home testing, stating, “Home/portable sleep studies with Type 3 monitoring devices [minimum of 4 parameters, including ventilation or airflow (at least 2 channels of respiratory movement, or respiratory movement and airflow), heart rate or ECG, and oxygen saturation] for adults are considered medically necessary as an alternative to standard polysomnography. …”
Two weeks ago, four DME MACs released their PAP policies, which included restrictions that home testing advocates say defeat the intent of home testing—to increase access.
“Anthem Blue Cross Blue Shield has approved home sleep testing for their private pay patients—CMS accounts for only 20% of the patient population,” says Terry Murphy, director of sales, North and South America, Embla. “The way it stands right now, if you were on Anthem Blue Cross Blue Shield, you would be receiving care as a private pay patient that, in essence, you won’t get if you are a Medicare patient.”
The Anthem Blue Cross Blue Shield policy can be found here.
