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ACG
​
h.o.l.M.E.S.

Automated Clinical Guidelines

Acoustic Pharyngometers and SNAP Testing System
Aetna
Bi-Level Positive Airway Pressure Devices
Anthem
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Facility Based Sleep Studies

Sleep

Humana
MA
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Facility Based Sleep Studies for Obstructive Sleep Apnea
Home Sleep Testing (HST)
Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
Anthem
Medicare
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Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea (L38276, L38307, L38398, L38387, L38310, L38312, L38385, L38528)

Indicates Non-covered Service

Management of Obstructive Sleep Apnea using Auto Titrating and Continuous Positive Airway Pressure Devices
Anthem
Sleep Studies-Adult
Aetna
Humana
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Actigraphy & Accelerometry

Indicates Non-covered Service

Aetna
Management of Obstructive Sleep Apnea using Oral Appliances
Anthem
Sleep Studies-Pediatric
Aetna
Humana
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Misc. Devices in the Management of Obstructive Sleep Apnea & Restless Legs Syndrome
Anthem
Multiple Sleep Latency Testing and Maintenance of Wakefulness Testing
Aetna
Anthem
Sleep Testing
FloridaBlue
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Tongue Neurostimulation for Obstructive Sleep Apnea 
Humana
Polysomnography and Home Sleep Apnea Testing
Anthem
Polysomnography for Non-Respiratory Sleep Disorders
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Sleep Studies
UHC

64582, 64583, 64584, 95782, 95783, 95800, 95801, 95805, 95806, 95807, 95808, 95810, 95811, A4604, A7027, A7028, A7029, A7030, A7031, A7032, A7033, A7034, A7035, A7036, A7037, A7038, A7039, A7044, A7045, A7046, C1767, D9947, D9948, E0470, E0471, E0485, E0486, E0561, E0562, E0601, E1399, G0398, G0399, G0400, 4A1ZXQZ

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