Medicare local coverage
Medicare coverage for Polysomnography and Other Sleep Studies (LCD)
3 Medicare Administrative Contractors publish a local coverage determination (LCD) for Polysomnography and Other Sleep Studies. The snapshot lists 3 LCD records: 3 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
CGS Administrators, LLCMAC - Part A, MAC - Part B | L36902 | Active | Feb 27, 2026 |
Noridian Healthcare Solutions, LLCMAC - Part A, MAC - Part B | L36861 | Active | Sep 2, 2025 |
WPS Insurance CorporationMAC - Part A, MAC - Part B | L36839 | Active | Jun 17, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A56903WPS Insurance CorporationUpdated Jun 18, 2025
- A57049CGS Administrators, LLCUpdated Feb 27, 2026
- A57697Noridian Healthcare Solutions, LLCUpdated Sep 4, 2025
CMS also lists 5 response-to-comments articles for this topic, where contractors answer public comments on the proposed LCD: A55430, A55491, A55492, A60188, A60189.
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Outpatient Sleep Studies
- Polysomnography and Sleep Testing
- Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
- Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
- Nerve Conduction Studies and Electromyography
- Non-Invasive Abdominal / Visceral Vascular Studies
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.