MedicaidCoverageMedium impact
Coverage for Home Sleep Study (Proc Codes 95800, 95801, and 95806)
Arkansas Medicaid·AR · Sleep Medicine, Internal Medicine, Pulmonology·Provider Notice
Effective date
Dec 3, 2025
We identified it
Dec 3, 2025
Summary
Arkansas has issued a provider notice regarding coverage for Home Sleep Study procedures (CPT 95800, 95801, 95806). The policy was posted on December 3, 2025, and appears to establish or clarify coverage parameters for these sleep study codes. However, the actual policy content is not available in this summary—only the title and source URL are provided.
Action Required
By December 10, 2025: Billing team must obtain and review the complete policy document from the Arkansas Department of Human Services (https://humanservices.arkansas.gov/wp-content/uploads/ON-036-25.docx) to understand coverage requirements for CPT 95800, 95801, and 95806. Determine if prior authorization is required, identify any documentation requirements, verify reimbursement rates, and confirm any coverage restrictions. Update billing system rules, encounter forms, and provider education materials accordingly. Until the full policy is reviewed, flag any claims for these codes for manual review to ensure compliance.