Using a Type III Home Sleep Tester in dental sleep medicine

Every day I am asked about using a home sleep tester to diagnose patients and how do you bill for that.

This is a very grey area and there are many different answers and opinions about this.

Medical doctors do not wish us to use an HST for diagnosis even if we send it to a board certified sleep physician.  In several states the medical board has influenced the dental boards to disallow the use of an HST for anything other than titration.

Many medical insurances and Medicare will not pay you for the diagnosis use of the HST. They require a face to face visit with a sleep physician and administration of the testing by him/her.  

If you treat a Medicare patient as a Medicare provider you can't refer the patient to do an HST online or use your tester and expect to be allowed to provide services. You have broken their rules and can be denied any future claims, even potential charges against you.

The only people we recommend an HST online is cash patients. Some patients with insurance and high deductibles become a cash patient due to their insurance not paying for treatment. These patients get the HST and they can try to submit the bill themselves, but the reality is the insurance will not pay and won't apply it towards their outpatient deductible. So you must let the patient know this before they order one.

To avoid any grey areas and angering the medical community and insurances we just reserve our HST for titration studies only.  You can bill the patient's medical insurance 90 days after delivery for the HST used in titration.  

I do believe every dental office treating sleep apnea needs to have and use an HST in the titration.  You can never know if you are titrated correct until you do the test.  For payment it is best to wait 90 days and then do the test.