Medicare AdvantageBilling CodesMedium impact
MA05.047o, Treatment of Obstructive Sleep Apnea (OSA) and Primary Snoring in Adults
Independence Blue Cross·Sleep Medicine, Oral & Maxillofacial Surgery, Dentistry +1 more·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Independence Blue Cross updated MA05.047o to MA05.047p, adding three new CPT codes (0964T, 0965T, 0966T) for custom jaw expansion oral prostheses for obstructive sleep apnea treatment effective July 1, 2025. The policy reissued on October 29, 2025 to communicate the company's continuing coverage position; no substantive coverage criteria changes were made.
Action Required
By July 1, 2025: Billing team must update billing system and fee schedules to recognize CPT codes 0964T, 0965T, and 0966T for custom jaw expansion oral prostheses for OSA. Update encounter forms and clinical documentation templates to support providers in capturing these services. Verify that prior authorization workflows align with existing OSA coverage criteria (certified sleep study diagnosis, AHI/RDI thresholds, CPAP intolerance documentation). Communicate to sleep medicine and dental/oral surgery providers that these new codes are now billable under MA05.047p effective July 1, 2025. Note that the October 29, 2025 reissuance is informational only and does not change coverage criteria.