Pricing Updates for Home Sleep Study

Published 09/07/2021

Palmetto GBA completed a fee review for codes G0398, G0399 and G0400 under the Jurisdiction J 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

AL

10112

00

$154.59

G0398 TC

AL

10112

00

$114.04

G0398 26

AL

10112

00

$40.55

G0398

GA

10212

01

$169.83

G0398 TC

GA

10212

01

$128.12

G0398 26

GA

10212

01

$41.72

G0398

GA

10212

99

$153.17

G0398 TC

GA

10212

99

$112.75

G0398 26

GA

10212

99

$40.42

G0398

TN

10312

35

$154.39

G0398 TC

TN

10312

35

$114.40

G0398 26

TN

10312

35

$39.99

CPT Code G0399

HCPCS Code/ Modifier

State

Carrier

Locality

Fee Effective 10/01/21

G0399

AL

10112

00

$94.80

G0399 TC

AL

10112

00

$50.84

G0399 26

AL

10112

00

$43.96

G0399

GA

10212

01

$102.25

G0399 TC

GA

10212

01

$57.04

G0399 26

GA

10212

01

$45.20

G0399

GA

10212

99

$94.08

G0399 TC

GA

10212

99

$50.26

G0399 26

GA

10212

99

$43.82

G0399

TN

10312

35

$94.17

G0399 TC

TN

10312

35

$50.77

G0399 26

TN

10312

35

$43.41

CPT Code G0400

HCPCS Code/ Modifier

State

Carrier

Locality

Fee Effective 10/01/21

G0400

AL

10112

00

$84.56

G0400 TC

AL

10112

00

$44.01

G0400 26

AL

10112

00

$40.55

G0400

GA

10212

01

$91.13

G0400 TC

GA

10212

01

$49.42

G0400 26

GA

10212

01

$41.72

G0400

GA

10212

99

$83.93

G0400 TC

GA

10212

99

$43.51

G0400 26

GA

10212

99

$40.42

G0400

TN

10312

35

$84.05

G0400 TC

TN

10312

35

$44.06

G0400 26

TN

10312

35

$39.99

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.