Sleep Medicine ICD-10 Codes & CPT Codes

Sleep medicine specialists diagnose and treat sleep disorders including obstructive sleep apnea, insomnia, narcolepsy, restless legs syndrome, and REM sleep behavior disorder. Codes on this page reflect the FY 2027 ICD-10-CM code set (CMS, effective October 1, 2026) and the CPT 2026 code set (AMA, effective January 1, 2026). Accurate ICD-10 coding and proper polysomnography billing are essential for Medicare and commercial payer reimbursement. This page lists the top codes used in sleep medicine practices.

FY 2027 ICD-10-CM (CMS, eff. 10/1/2026) · CPT 2026 (AMA) · Codes checked against the FY 2027 ICD-10-CM tabular (CMS) · October 2026 · Last verified: October 2026

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Top ICD-10 Codes for Sleep Medicine

ICD-10 Code Description Billable
G47.33 Obstructive sleep apnea (adult)(pediatric) ✓
G47.30 Sleep apnea, unspecified ✓
G47.00 Insomnia, unspecified ✓
G47.10 Hypersomnia, unspecified ✓
G47.61 Periodic limb movement disorder ✓
G47.411 Narcolepsy with cataplexy ✓
G47.419 Narcolepsy without cataplexy ✓
F51.01 Primary insomnia ✓
G47.63 Sleep related bruxism ✓
G47.20 Circadian rhythm sleep disorder, unspecified type ✓
R06.83 Snoring ✓
G47.52 REM sleep behavior disorder ✓
F51.3 Sleepwalking [somnambulism] ✓
G47.69 Other sleep related movement disorders ✓
F51.11 Primary hypersomnia ✓
G47.31 Primary central sleep apnea ✓
G47.32 High altitude periodic breathing ✓
G47.34 Idiopathic sleep-related nonobstructive alveolar hypoventilation ✓
G47.35 Congenital central alveolar hypoventilation syndrome ✓
G47.36 Sleep related hypoventilation in conditions classified elsewhere ✓
G47.37 Central sleep apnea in conditions classified elsewhere ✓
G47.39 Other sleep apnea ✓
G47.01 Insomnia due to medical condition ✓
G47.09 Other insomnia ✓
G47.11 Idiopathic hypersomnia with long sleep time ✓
G47.12 Idiopathic hypersomnia without long sleep time ✓
G47.13 Recurrent hypersomnia ✓
G47.14 Hypersomnia due to medical condition ✓
G47.19 Other hypersomnia ✓
G47.21 Circadian rhythm sleep disorder, delayed sleep phase type ✓
G47.22 Circadian rhythm sleep disorder, advanced sleep phase type ✓
G47.23 Circadian rhythm sleep disorder, irregular sleep wake type ✓
G47.24 Circadian rhythm sleep disorder, free running type ✓
G47.25 Circadian rhythm sleep disorder, jet lag type ✓
G47.26 Circadian rhythm sleep disorder, shift work type ✓
G47.29 Other circadian rhythm sleep disorder ✓
G47.51 Confusional arousals ✓
G47.54 Parasomnia in conditions classified elsewhere ✓
G47.59 Other parasomnia ✓
F51.4 Sleep terrors [night terrors] ✓
G25.81 Restless legs syndrome ✓

Source: CMS ICD-10-CM Official Code Set FY 2027

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Common CPT Codes for Sleep Medicine Billing

CPT Code Description Medicare Rate* Common Modifiers
95810 Polysomnography; age 6 years or older, attended by a technologist, with sleep staging, includes 4 or more additional parameters ~$674 -26, -TC
95811 Polysomnography; age 6 years or older, attended, with sleep staging and CPAP titration ~$708 -26, -TC
95800 Sleep study, unattended, simultaneous recording: heart rate, oxygen saturation, respiratory analysis, and sleep time ~$141 -26, -TC, -59
95801 Sleep study, unattended, simultaneous recording; minimum of heart rate, oxygen saturation, and respiratory analysis (e.g., by airflow or peripheral arterial tone) ~$104 -26, -TC
95803 Actigraphy testing, recording, analysis, interpretation and report, minimum of 72 hours ~$135 -26
95805 Multiple sleep latency or maintenance of wakefulness testing, recording, analysis and interpretation ~$480 -26, -TC
95806 Sleep study, unattended, simultaneous recording: heart rate, oxygen saturation, respiratory airflow, and respiratory effort ~$103 -26, -TC, -59
95807 Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, oxygen saturation; attended by a technologist ~$444 -26, -TC
95808 Polysomnography; any age, attended by a technologist, with sleep staging, includes 1-3 additional parameters ~$512 -26, -TC
95782 Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, attended by a technologist See PFS -26, -TC
95783 Polysomnography; younger than 6 years, sleep staging with 4 or more additional parameters of sleep, with initiation of continuous positive airway pressure therapy or bi-level ventilation, attended by a technologist See PFS -26, -TC
G0398 HCPCS Level II (Medicare): Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: EEG, EOG, EMG, ECG/heart rate, airflow, respiratory effort and oxygen saturation See PFS -26, -TC
G0399 HCPCS Level II (Medicare): Home sleep test (HST) with type III portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ECG/heart rate and 1 oxygen saturation See PFS -26, -TC
G0400 HCPCS Level II (Medicare): Home sleep test (HST) with type IV portable monitor, unattended; minimum of 3 channels See PFS -26, -TC
99213 Office or other outpatient visit, established patient, low level of MDM, or 20 minutes or more total time on the date of the encounter ~$95 -25, -95 (telehealth; payer-specific), -93 (audio-only)
99214 Office or other outpatient visit, established patient, moderate level of MDM, or 30 minutes or more total time on the date of the encounter ~$136 -25, -95 (telehealth; payer-specific), -93 (audio-only)
99215 Office or other outpatient visit, established patient, high level of MDM, or 40 minutes or more total time on the date of the encounter ~$192 -25, -95 (telehealth; payer-specific), -93 (audio-only)
99205 Office or other outpatient visit, new patient, high level of MDM, or 60 minutes or more total time on the date of the encounter ~$237 -25, -95 (telehealth; payer-specific), -93 (audio-only)
94660 Continuous positive airway pressure ventilation (CPAP), initiation and management ~$69 -59/-XU (when separately distinct)
94762 Noninvasive oximetry for oxygen saturation; by continuous overnight monitoring ~$24 -26, -TC
99401 Preventive medicine counseling and/or risk factor reduction, individual, approximately 15 minutes; only for patients WITHOUT a diagnosed sleep disorder (for diagnosed insomnia/OSA, counseling is included in the E/M; count time toward 99213-99215) ~$40 -25
98984 Remote therapeutic monitoring device supply for respiratory system data (e.g., PAP/CPAP adherence), 2-15 days in a 30-day period ~$52 -GP/-GO/-GN (therapist under plan of care only)
98979 Remote therapeutic monitoring treatment management, first 10-19 minutes per calendar month (requires live interactive communication) ~$26 -GP/-GO/-GN (therapist under plan of care only)
E0601 HCPCS Level II — Continuous positive airway pressure (CPAP) device, DME rental N/A -RR, -KX

*Approximate 2026 CMS national non-facility rate. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates.

Modifier notes: Append -25 to the same-day E/M, not to 94660. Medicare telehealth is reported with POS 02/10 (plus modifier 95 where CMS requires it); GT applies only to CAH Method II billing. Check the status of Medicare telehealth flexibilities for the date of service. RTM codes 98984 and 98979 are not telehealth services, so modifier 95 does not apply; a 98984 device-supply period requires at least 2 days of data in the 30-day period.

Top Denial Reasons for Sleep Medicine Claims

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Medical Necessity Not Adequately Documented

Before a sleep study, document symptoms, the Epworth score and relevant comorbidities, plus (Medicare) an in-person or telehealth face-to-face clinical evaluation performed BEFORE the sleep test. For CPAP coverage, document a qualifying AHI/RDI from the interpreted PSG or HST (Medicare NCD 240.4: AHI/RDI of 15/hr or more, or 5-14/hr with excessive daytime sleepiness, impaired cognition, mood disorder, insomnia, hypertension, ischemic heart disease, or history of stroke). Failed conservative measures is not a Medicare CPAP criterion.

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Missing or Incorrect Prior Authorization for Sleep Studies

Many commercial payers require prior authorization for polysomnography (95810, 95811) and home sleep testing before the study is performed. Verify payer requirements in advance and document the auth number on the claim.

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Incorrect Diagnosis-Procedure Code Linkage

Billing CPT 95811 (CPAP titration PSG) with only a snoring diagnosis (R06.83) without a confirmed or suspected sleep apnea code (G47.30, G47.33) triggers automatic denial. Ensure the linked ICD-10 code supports the clinical necessity of the procedure.

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Split-Bill Issues: Missing Modifier -26 or -TC

When the interpreting physician and the facility are billing separately for sleep studies, failure to append modifier -26 (professional component) or -TC (technical component) results in duplicate-service denials. Always split-bill with the correct modifier when the physician does not own the testing equipment.

Sleep Medicine Billing & Coding Tips

  • G47.33 (obstructive sleep apnea) is distinct from G47.31 (primary central sleep apnea) and G47.30 (unspecified sleep apnea); specify the type based on the sleep study interpretation.
  • Polysomnography (95810) requires sleep staging (EEG, EOG, and submental EMG) plus at least 4 additional parameters (for example airflow, respiratory effort, oxygen saturation, ECG/heart rate, limb EMG). With only 1-3 additional parameters, report 95808.
  • CPAP titration study (95811) must be a full attended polysomnography with CPAP applied. Home sleep apnea tests (95800) cannot be used for titration.
  • Document the AHI, RDI, and nadir oxygen saturation in every sleep study interpretation report to support G47.33 diagnosis and CPAP/BiPAP equipment orders.

Frequently Asked Questions

What is the ICD-10 code for sleep apnea?

G47.33 is Obstructive Sleep Apnea (OSA), the most common sleep apnea code. G47.31 is Primary central sleep apnea. Central sleep apnea due to an underlying condition (e.g., heart failure/Cheyne-Stokes) is coded G47.37, with the underlying condition sequenced first. G47.30 is unspecified and should be avoided when the type has been determined by sleep study. The OSA code supports CPAP/BiPAP equipment orders and prior authorization.

What is the difference between 95810 and 95811?

95810 is a diagnostic polysomnography (sleep staging with 4+ parameters) without PAP therapy. 95811 is a CPAP titration polysomnography, performed when OSA has already been diagnosed and CPAP pressure needs to be set. Both require a technologist in attendance.

Can a home sleep test diagnose OSA?

Yes. Unattended home sleep tests (CPT 95800/95801/95806 or HCPCS G0398-G0400, depending on payer) can diagnose OSA; Medicare accepts Type II-IV HST results to qualify for PAP (NCD 240.4). AASM recommends HSAT for uncomplicated adults with high pretest probability. Check your local MAC sleep-testing LCD for any additional limits. A home test cannot be used for CPAP titration; a full in-lab polysomnography (95811) is required for titration.

How is a split-night sleep study billed?

A split-night study (a diagnostic portion followed by CPAP titration on the same night) is reported once with 95811 for patients age 6 or older. Do not report 95810 and 95811 together for the same night.

What is the ICD-10 code for insomnia?

G47.00 is Insomnia, unspecified. F51.01 is Primary insomnia (when no underlying medical or psychiatric cause is identified). G47.01 is Insomnia due to a medical condition. Code the most specific type supported by the documentation.

How does OmniMD support sleep medicine practices?

OmniMD’s Sleep Medicine EHR integrates polysomnography report uploads, AHI-based diagnosis coding suggestions, CPAP compliance tracking (from ResMed/Philips data feeds), and DME order management with medical necessity documentation.

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