2025 is here, and managing billing for your sleep study center is about to get trickier. Staying on top of the latest updates is like keeping a ship on course. Understanding the changes to CPT codes, physician payments, and telehealth policies is the key to avoiding errors and ensuring smooth billing. Now, it is really important to know about the major updates on sleep study billing services. 

3 major updates on the billing process for your sleep study in 2025:

1. New changes in Medicare physician payment: 

Medicare's payment system will change in 2025, impacting billing for sleep study labs. The payment conversion factor has dropped to $32.3465. A 2.83% decrease from 2024, meaning lower reimbursements for both attended and unattended sleep studies. The AASM is working to push for a new law to increase payments later this year. 

2 Newly updated CPT codes: 

Accurate CPT codes are crucial for maintaining a healthy billing practice. Here are the latest coding updates to follow this year: 

1. G2211: CMS has updated the rules for code G2211, offering more flexibility in billing. Now, G2211 can be billed even on the same day as other services like preventive care, annual wellness visits, or vaccinations. This update will allow somnologists to confidently bill for these services without the concern of payment issues. 
2. CPT code 95800: You must know that this particular code has been already flagged as non-active. It happened because of the increasing use of disposable equipment related to unattended sleep studies. AASM has already started collaborating with other organizations to have those codes updated. These changes will ensure that sleep study specialists can accurately report services using modern technologies and address a wider range of sleep disorders. Additionally, the proper modifier will be essential to ensure correct coding and reimbursement under these updated guidelines. This effort aims to better reflect the evolving landscape of sleep medicine and ensure accurate billing practices. 
3. CPT code 98016: A new code, 98016, has replaced the old G2012 code for quick consultations or assessments over the phone or video calls. This would make sleep study billing easier for brief discussions before scheduling a full sleep study. 

3 The latest changes in telehealth policies: 

1. CMS has reinstated old rules for telehealth. It will limit services to Medicare patients in rural areas or places with healthcare worker shortages. For example, patients in rural areas can still access telehealth, but more widespread access depends on the new Telehealth Modernization Act of 2024. 
2. Another key update is that audio-only calls are still allowed for Medicare telehealth. It is going to make remote consultations and follow-ups for sleep studies easier in the coming days. 

Staying updated with the 2025 changes in billing services is crucial for maintaining quality care and keeping up with new policies, reimbursements, and telehealth rules. To avoid feeling overwhelmed, outsource your sleep study billing services. A professional billing provider can streamline your billing process, improve cash flow, and ensure smoother revenue outcomes, allowing you to focus more on patient care. 

So, do not run behind your competitors. Hire a perfect billing partner and stay ahead of the curve!