Medical Billing · Nationwide
Sleep Medicine & Polysomnography Medical Billing Services
In-lab polysomnography (PSG), Home Sleep Apnea Testing (HSAT Types II–IV), split-night CPAP titrations, and 90-day PAP compliance adherence tracking.
Aethera Healthcare Solutions provides full-service medical billing and revenue cycle management to sleep disorders centers, accredited sleep labs, and polysomnography practices across the United States. We handle coding, claims, payment posting, denial management, and A/R follow-up end to end — so your team can stay focused on patient care while your revenue cycle runs cleanly.
Typical sleep medicine & polysomnography CPT range we work: 95800, 95806, 95810, 95811, 95782, G0398–G0400, 94660.
Why sleep medicine & polysomnography billing leaks revenue
Home Sleep Apnea Test (HSAT) vs in-lab prior-authorization denials: Payers mandating tiered home testing (CPT 95800/95806) before approving in-lab PSG (CPT 95810)
Split-night diagnostic & titration criteria failures: Denials for CPT 95811 when diagnostic recording time is under 2 hours or AHI criteria are not satisfied
CMS 90-day CPAP compliance recoupments: Payer clawbacks for durable medical equipment CPAP rentals when 4+ hours/night for 70% of 30 consecutive days is unverified
Place of Service (POS 11 vs 22 vs 12) split-billing errors: Rejections when home sleep tests (POS 12) or facility-based labs (POS 22) are billed with incorrect technical vs professional modifiers (TC/26)
How Aethera fixes it
Specialty-trained coders (CPC/CCS) code to the documentation
First-pass claim scrubbing against payer and NCCI edits
Proactive denial prevention and 72-hour denial work
Relentless A/R follow-up to drive days-in-A/R down
Eligibility and prior-auth verification before service
Transparent, real-time reporting in the provider portal
Free tools for your billing team
Use these any time — no login required.
Sleep Medicine & Polysomnography billing FAQ
What clinical documentation is required to overturn in-lab PSG prior-authorization denials?
We package complete Epworth Sleepiness Scale (ESS >= 10) scores, documented cardiopulmonary or neuromuscular comorbidities (CHF, COPD, stroke history), physical airway exams (Mallampati IV), and prior failed or inconclusive HSAT reports.
How do you prevent CPAP setup and DME rental recoupments?
We integrate with CPAP cloud telemetry platforms (AirView, Care Orchestrator) to capture 30-day adherence compliance data and physician face-to-face re-evaluation documentation before submitting 90-day compliance attestations.