2025 CPT code 95800
(Active) Effective Date: N/A Medicine - Sleep Medicine Feed
Unattended sleep study recording heart rate, oxygen saturation, respiratory analysis, and sleep time.
Modifiers 26, 52, TC are applicable.
Medical necessity for 95800 is based on the clinical suspicion of a sleep disorder that requires objective measurement of physiological parameters during sleep.Common indications include suspected sleep apnea, periodic limb movement disorder, insomnia, or other sleep-related breathing disorders.
In simple words: This is a sleep test you can do at home, without a technician present. It measures your heart rate, oxygen levels, breathing patterns, and how long you sleep.
This code represents a sleep study performed without a technician or healthcare professional physically present.It involves the simultaneous recording of heart rate, oxygen saturation, respiratory analysis (either by airflow or peripheral arterial tone), and sleep time. The service includes recording, analysis, interpretation, and a report.
Example 1: A patient with suspected sleep apnea is set up with a portable monitoring device at home to record heart rate, oxygen saturation, respiratory analysis, and sleep time overnight., A child with suspected periodic limb movement disorder undergoes an unattended sleep study at home., A patient with insomnia has a home sleep study to assess sleep onset and maintenance.
Documentation should include the duration of the recording, heart rate data, oxygen saturation levels, respiratory analysis findings, and total sleep time. Any technical difficulties or interruptions in recording should also be noted. The medical necessity for the study should be clearly documented.
- Modifier TC rule: Modifier TC can be used for the technical component of the service, when appropriate.
- Specialties:Sleep Medicine, Pulmonary Medicine
- Place of Service:Home