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Reimbursement problems for Psych --> Sleep?

Discussion in 'Sleep Medicine' started by BobA, 05.16.09.

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  1. BobA

    BobA Member

    SDN 7+ Year Member

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    Do psychiatrists who have done a Sleep Fellowship and who are board certified in Sleep face difficulties with re-imbursement?

    I ask because of this article. The relevant text is listed below.

    "After completing a sleep-medicine fellowship at Beth Israel Deaconess Medical Center in Boston in 2004, Martha Praught, M.D., entered private practice in Brookline, Mass.

    She has diagnosed sleep disorders in patients with psychiatric problems including mood disorders, attention-deficit/hyperactivity disorder, schizophrenia, and menopausal issues.

    "It's a challenge to stay active in sleep medicine in a private-practice situation," she said. "Not all insurers reimburse psychiatrists for diagnosing and treating sleep disorders. That has to change.""
  2. Manicsleep

    Manicsleep Chief Resident

    Attending Physician
    SDN 5+ Year Member
    My institution wont even let me read my own studies. They get a non fellowship trained pulmonologist to do it.

    The results are terrible!

    They are in the process of hiring a sleep trained pulm person however would not consider me for the job. The politics are astounding.

    The problem is that the job pays well and otherwise I have no complaints. I have to decide whether to give up on sleep or leave in about a year once financially stable and start a private practice (which has its own headaches).
  3. hyoglossus

    hyoglossus New Member

    You can be credentialled as psychiatry- sleep medicine with medicare. You may not be able to bill for OSA as a primary diagnosis because it is a medical disorder even though it has a DSM code. You can certainly bill the modifier 26 for the professional component of the PSG. You would have taken a sleep history in your psych evaluation.

    The hospitals are slow to catch on which is good for those in private practice. You may want to send your PSG to a private lab to read.
  4. Shikima


    Attending Physician
    Physician SDN 7+ Year Member
    I know this is an old thread but my understanding was that once you're sleep MEDICINE fellowship trained, you have all the rights in billings for appropriate sleep codes, regardless of being psych trained first.

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