Medicare compliance activity – sleep studies

22 March 2022

The Department of Health has informed ASA of upcoming compliance activities in relation to billing for sleep studies. The ASA has written a letter requesting a postponement of this compliance activity, which also provides information about why some providers might have higher billing than others. However no response has been received as yet, and the compliance activity was due to commence this Thursday 24 March. 

The Department’s notification offers this information: ”We are initiating a targeted compliance letter activity relating to the claiming of Sleep Study MBS items 12203 and 12250 during the period 1 October 2020 to 30 September 2021. On 24 March 2022, the Department intends to write to 64 providers encouraging them to review their processes and ensure their claiming meets the MBS requirements.” A copy of the letter that may be sent out has been provided.

For questions about this issue, contact the CEO Marcia Balzer. We will keep members informed if a response is received to our request for a postponement. 

EDIT 25 March 2022: A response to our letter on this issue to the Department of Health has been received. You can read it here.