Quick answer: For dates of service on or after January 1, 2027, bill a home sleep apnea test with the six new CPT 2027 unattended sleep study codes, not 95800, 95801 or 95806. Three technical and three interpretation-and-report codes each come in low, moderate and high complexity, set by channels recorded and parameter categories generated (91 FR 43888). The final code numbers are published in the AMA CPT 2027 code set; the CY 2027 proposed rule used placeholder designations, not final numbers, so take the numbers from your CPT 2027 code set, and ask your MAC in writing whether Medicare still requires G0398, G0399 or G0400. Medicare values are proposed; the final rule had not been published as of November 2, 2026.
Our announcement post covers what changed; this one covers how to bill it, and will be updated when the CY 2027 final rule publishes.
The 2027 codes and what each tier requires
The CPT Editorial Panel’s February 2025 action deleted 95800, 95801 and 95806 and added six codes effective January 2027. The proposed rule and Addendum B use placeholders (95X18, 95X19, 95X20, 95X21, 95X22, 95X23); the AMA’s September 9, 2026 release does not list final numbers. Load numbers and descriptors from your licensed CPT 2027 code set.
| Tier (91 FR 43888) | Technical code (proposed-rule placeholder, not the final CPT number): proposed total RVUs | Interpretation code (proposed-rule placeholder, not the final CPT number): proposed work / total RVUs |
|---|---|---|
| Low: 3-4 channels that generate at least 3-5 parameter categories | 95X18: 1.76 (about $57.80, proposed) | 95X21: 0.81 / 1.19 (about $39.08, proposed) |
| Moderate: 5-10 channels that generate at least 6-8 parameter categories | 95X19: 1.90 (about $62.40, proposed) | 95X22: 1.05 / 1.50 (about $49.26, proposed) |
| High: 11 or more channels that generate at least 9 parameter categories | 95X20: 4.53 (about $148.77, proposed) | 95X23: 1.42 / 2.09 (about $68.64, proposed) |
Dollars are proposed, unadjusted national figures: total RVUs times the proposed non-qualifying APM conversion factor of 32.8409 (91 FR 44241). CMS proposed 1.42 work RVUs for high-complexity interpretation, below the RUC’s 1.60, and questioned two-night device time, so values may move (91 FR 43889). Model in RVUs until the final rule posts.
From the deleted codes to the 2027 structure
| Deleted code (through December 31, 2026) | 2027 replacement | What changed |
|---|---|---|
| 95800: heart rate, oxygen saturation, respiratory analysis, sleep time | A technical and an interpretation code at the supported tier | Channel and parameter-category counts set the tier |
| 95801: minimum of heart rate, oxygen saturation, respiratory analysis | Same pair | The lowest tier starts at 3-4 channels |
| 95806: heart rate, oxygen saturation, airflow, respiratory effort | Same pair | More channels may reach a higher tier |
| TC and 26 modifiers | Separate technical and professional codes | Proposed Addendum B shows no TC, 26 or global line |
Old descriptors are from the AASM code list. The proposed rule gives no crosswalk and does not say whether one entity may report both codes or whether both must share a tier; confirm with CPT 2027 guidelines and payers.
Attended studies and device types
The new codes cover unattended studies only. Attended codes 95807, 95808, 95810 and 95811 keep their TC and 26 lines in proposed Addendum B, though the Panel revised the sleep testing guidelines in September 2025. CGS article A57049 requires proof that 95808, 95810 and 95811 were performed in a facility sleep lab.
The new descriptors name no device type, but Medicare coverage does. Under NCD 240.4.1, Type II monitors have at least 7 channels; Type III at least 4, including airflow or respiratory movement, heart rate or ECG, and oxygen saturation; Type IV devices are covered only with three or more channels, one of them airflow; devices with three or more channels that include actigraphy, oximetry and peripheral arterial tone are also covered. A three-channel study can fit the low tier and still fail the NCD.
Studies that straddle December 31, 2026 and January 1, 2027
The deleted codes end with December 31, 2026 dates of service; the new codes start January 1, 2027. As of November 2, 2026, no CMS or AMA material we reviewed addresses a study recorded overnight on December 31 or interpreted in January. Until one does, schedule late-December pickups so recording and interpretation fall in the same year; for any study that straddles, chart each recording night and the interpretation date, and hold the claim until the payer answers in writing.
Medicare: G0398, G0399 and G0400
CGS article A57049 (revision effective March 5, 2026) says a home study on a Type II, III or IV monitor that meets the G-code descriptors must be billed with the most specific of G0398, G0399 or G0400, which describe Type II (minimum 7 channels), Type III (minimum 4 channels) and Type IV (minimum 3 channels) home tests. The proposed rule does not mention them, and none appears in proposed Addendum B. Their 2027 status is unresolved: build both sets of charge lines and activate what your MAC confirms.
Documentation each HSAT claim needs
- The treating physician’s order in the record (A57049).
- A comprehensive sleep evaluation showing high pretest probability of moderate to severe OSA, and documented device instruction.
- A report naming the device type, every channel recorded and the parameter categories generated.
- Retained recording data and a signed, dated interpretation.
- Justification for any second home test in a year; CGS expects no more than one.
Denials to expect in January
- A deleted code (95800, 95801 or 95806) or a placeholder on a 2027 date of service.
- A tier the report’s channel list does not support.
- A diagnosis not yet listed for the new codes: the home-test group in A57049 still names only 95800, 95801, 95806, G0398, G0399 and G0400.
- No contracted rate for the new codes.
- A 2026 authorization naming a deleted code for a 2027 study.
Payer policy and prior authorization
Commercial and Medicare Advantage plans set their own coverage, payment and authorization policies for new CPT codes, and the AASM advises checking which home-test codes each insurer accepts. Ask each payer in writing which codes it will take on January 1, 2027, request rates for all six, and rebuild authorization templates around the new codes.
2027 HSAT claim checklist
- Load final codes from CPT 2027.
- Retire 95800, 95801 and 95806 for dates of service on or after January 1, 2027.
- Map each device to a tier by documented channels and parameter categories, and to its NCD 240.4.1 type.
- When two entities share a study, record who reports each code.
- Get your MAC’s written answer on CPT codes versus G0398, G0399 and G0400.
- Update report templates to list device type and channels.
- Hold every study that straddles December 31, 2026.
- Swap in final RVUs when the final rule posts.
- Review the first January HSAT claims by hand.
How AMS handles the transition for sleep clients
AMS Solutions, physician-founded in 1992 and headquartered in Dallas, runs credentialing and billing under one roof. For our sleep medicine billing clients, we map each device to its tier, get written payer answers on code acceptance, track year-end studies, and reload fees when final values publish. To review your HSAT claims before January, start with a free billing audit.
FAQs
What replaces CPT 95800, 95801 and 95806 in 2027?
Six unattended sleep study codes: three technical and three interpretation-and-report codes, each at low, moderate or high complexity by channels recorded and parameter categories generated. The proposed rule used placeholder designations; the final numbers are in the AMA CPT 2027 code set.
Can a sleep center still bill a home sleep test globally in 2027?
Expect two lines. CMS’s proposed Addendum B shows no global, TC or 26 line for the new codes. Confirm in CPT 2027 guidelines.
Will Medicare still accept G0398, G0399 and G0400 in 2027?
Unresolved as of November 2, 2026. CGS article A57049 requires them today, but the CY 2027 proposed rule omits them. Ask your MAC in writing.
How do I bill a home sleep test recorded on December 31, 2026?
No CMS or AMA instruction addresses it yet. Document recording and interpretation dates and hold the claim until the payer confirms in writing which code set applies.
What will Medicare pay for the new home sleep test codes?
Only proposed values exist: total RVUs of 1.76, 1.90 and 4.53 for the technical codes and 1.19, 1.50 and 2.09 for the interpretation codes. Final values come with the CY 2027 final rule.
Reviewed November 2, 2026.
Sources: AMA, CPT 2027 code set release (September 9, 2026); AMA CPT Panel summaries, February and September 2025; CMS, CY 2027 PFS proposed rule, Federal Register 2026-14327, and Addendum B; CMS, NCD 240.4.1; CGS, article A57049; AASM, Sleep Medicine Codes. 2027 values are proposed; not legal advice.
