G0399 Home sleep test/type 3 portaHome 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
Status C: contractor-priced by the MAC.
9 of 10 payer prior-auth lists that name G0399 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Michigan, Molina Healthcare of Texas, Molina Healthcare of Utah, Molina Healthcare of Washington.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Illinois | Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) | IL | prior auth required | eviCore-managed | Jan 1, 2025 | Procedure Code List, Effective 1/1/2025 |
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
| Molina Healthcare of California | Medicare Advantage | CA | prior auth required | Jul 1, 2021 | Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021 | |
| Molina Healthcare of Florida | Medicare Advantage | FL | prior auth required | vendor review only eviCore in IL/MI/OH/NY/WI | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021 |
| Molina Healthcare of Idaho | Medicare Advantage | ID | prior auth required | vendor review only eviCore in IL/MI/OH/NY/WI | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021 |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Contact eviCore for PA | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 |
| Molina Healthcare of Texas | Exchange | TX | prior auth required | Jul 1, 2021 | Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026 | |
| Molina Healthcare of Utah | Medicare Advantage | UT | prior auth required | vendor review only eviCore in IL/MI/OH/NY/WI | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021 |
| Molina Healthcare of Washington | Medicare Advantage | WA | prior auth required | vendor review only eviCore in IL/MI/OH/NY/WI | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021 |
G0399 appears in 13 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Obstructive Sleep Apnea in Adults (0004) | covered if criteria are met | Oct 6, 2026 | payer document |
| Aetna | Obstructive Sleep Apnea in Children (0752) | not covered | Oct 30, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Sleep Disorders (L.2.01.415) | listed, no stance | payer document | |
| Blue Shield of California | Diagnosis of Obstructive Sleep Apnea Syndrome (2.01.18) | listed, no stance | payer document | |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Diagnosis of Obstructive Sleep Apnea Syndrome (MED204.005) CPT Codes 94660, 94762, 95782, 95783, 95800, 95801, 95805, 95806, 95807, | listed, no stance | Oct 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (2026T0334SS) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (CS098.AE) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for Idaho Only) (CS098ID.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for Kansas Only) (CS098KS.03) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for Kentucky Only) (CS098KY.10) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for Nebraska Only) (CS098NE.C) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for New Mexico Only) (CS098NM.D) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Sleep Studies (for Ohio Only) (CS098OH.D) | listed, no stance | Jul 1, 2026 | payer document |
Prior authorization required or conditional in IN.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.