What insurance policy changes affect CPT 95807?

There are 6 tracked policy changes affecting CPT 95807, including updates from Humana, Devoted Health, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 95807?

Payers that have issued tracked updates for CPT 95807 include: Humana, Devoted Health, Independence Blue Cross.

How do I get notified when CPT 95807 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 95807. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 95807?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

95807 — A doctor or technician monitored your sleep overnight to diagnose sleep disorders like apnea or insomnia.: Insurance Policy Changes

95807 Insurance Policy Changes

CPT 95807, in plain terms, covers A doctor or technician monitored your sleep overnight to diagnose sleep disorders like apnea or insomnia. CPT 95807 is referenced in 6 tracked payer policy changes from Humana, Devoted Health, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 95807 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Medium impact

07.03.05ac, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies

Independence Blue Cross·Effective Sep 19, 2026

Independence Blue Cross has updated policy 07.03.05ac to delegate sleep disorder testing and PAP therapy utilization management back to Carelon Medical Benefits Management (previously delegated to AIM Specialty Health). Six procedure codes (CPT 95800, 95801, 95806 and HCPCS G0398, G0399, G0400) have been removed from the policy. The policy emphasizes requirements for standard written orders, proof of delivery, and adherence to Carelon's Clinical Appropriateness Guidelines for medical necessity determination.

95807 Insurance Policy Changes

Facility Based Sleep Studies - Medicare Advantage (Revised)

Q3 2026 newsletter

MA07.058n, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies

07.03.05ac, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies

07.03.05ac, Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies

Facility Based Sleep Studies - Medicare Advantage (Revised)