CMS Announces Proposed Decision Re: In Home Sleep Monitoring

... US regulatory ruling issued December 14th, concerning in-home reimbursement for diagnostic services for the second largest known sleep
disorder sleep apnea ...

On December 14th, a US government agency known as Centers for Medicare/Medicaid Services (CMS) announced a proposed decision to "expand coverage of CPAP to include those beneficiaries with a diagnosis of CPAP made using a combination of a clinical evaluation and unattended home sleep monitoring" using certain testing devices. While the ruling is not final, and is subject to change in the next few months, it is highly likely that numerous forms of in-home testing will be subject to reimbursement.

Another aspect of the proposed CMS decision suggests limiting reimbursement to certain patients only if their sleep apnea responds favorably after 12 weeks of treatment with a CPAP. Avastra believes
that it is likely that the decision will increase CPAP distribution to patients, and a substantial number of patients will not respond positively to such treatment. Those patients, who may have more complex sleep disorders, will likely require more thorough diagnosis in a laboratory setting.