Pricing Updates for Home Sleep Study
Palmetto GBA completed a fee review for codes G0398, G0399 and G0400 under the Jurisdiction M contract — pricing updates for home sleep study (HST). The fee is being changed effective dates of service October 1, 2021.
CPT® Code G0398
|
HCPCS Code/ Modifier |
State |
Carrier |
Locality |
Fee Effective 10/01/21 |
|---|---|---|---|---|
|
G0398 |
SC |
11202 |
01 |
$156.28 |
|
G0398 TC |
SC |
11202 |
01 |
$115.88 |
|
G0398 26 |
SC |
11202 |
01 |
$40.40 |
|
G0398 |
VA |
11302 |
00 |
$169.40 |
|
G0398 TC |
VA |
11302 |
00 |
$127.73 |
|
G0398 26 |
VA |
11302 |
00 |
$41.67 |
|
G0398 |
WV |
11402 |
16 |
$150.90 |
|
G0398 TC |
WV |
11402 |
16 |
$110.29 |
|
G0398 26 |
WV |
11402 |
16 |
$40.61 |
|
G0398 |
NC |
11502 |
00 |
$159.96 |
|
G0398 TC |
NC |
11502 |
00 |
$119.12 |
|
G0398 26 |
NC |
11502 |
00 |
$40.84 |
CPT® Code G0399
|
HCPCS Code/ Modifier |
State |
Carrier |
Locality |
Fee Effective 10/01/21 |
|
G0399 |
SC |
11202 |
01 |
$95.35 |
|
G0399 TC |
SC |
11202 |
01 |
$51.53 |
|
G0399 26 |
SC |
11202 |
01 |
$43.82 |
|
G0399 |
VA |
11302 |
00 |
$102.03 |
|
G0399 TC |
VA |
11302 |
00 |
$56.87 |
|
G0399 26 |
VA |
11302 |
00 |
$45.16 |
|
G0399 |
WV |
11402 |
16 |
$93.34 |
|
G0399 TC |
WV |
11402 |
16 |
$49.34 |
|
G0399 26 |
WV |
11402 |
16 |
$44.00 |
|
G0399 |
NC |
11502 |
00 |
$97.31 |
|
G0399 TC |
NC |
11502 |
00 |
$53.03 |
|
G0399 26 |
NC |
11502 |
00 |
$44.28 |
CPT® Code G0400
|
HCPCS Code/ Modifier |
State |
Carrier |
Locality |
Fee Effective 10/01/21 |
|
G0400 |
SC |
11202 |
01 |
$85.07 |
|
G0400 TC |
SC |
11202 |
01 |
$44.67 |
|
G0400 26 |
SC |
11202 |
01 |
$40.40 |
|
G0400 |
VA |
11302 |
00 |
$90.94 |
|
G0400 TC |
VA |
11302 |
00 |
$49.27 |
|
G0400 26 |
VA |
11302 |
00 |
$41.67 |
|
G0400 |
WV |
11402 |
16 |
$83.24 |
|
G0400 TC |
WV |
11402 |
16 |
$42.63 |
|
G0400 26 |
WV |
11402 |
16 |
$40.61 |
|
G0400 |
NC |
11502 |
00 |
$86.78 |
|
G0400 TC |
NC |
11502 |
00 |
$45.94 |
|
G0400 26 |
NC |
11502 |
00 |
$40.84 |
Inclusion or exclusion of a fee schedule amount for an item or service does not imply any health insurance coverage.
Note: CPT® codes and modifiers begin with a numeric character and HCPCS codes and modifiers being with an alpha character.