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See a sample rate comparisonHCPCS G0398 Fee Schedule
HCPCS G0398 is classified under Procedures / Professional Services, in the Sleep Studies, In Home subgroup.
Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation
| Key Fact | Detail |
|---|---|
| Service Type | Procedures / Professional Services Sleep Studies, In Home |
| Hospital Outpatient Group (APC) | APC 5722 - Level 2 Diagnostic Tests and Related Services |
| Common Revenue Codes | 05190740Sign up to view all 16 |
| Medicaid Fee Schedule | $135.17 median of the 6 states in the free previewView Medicaid rates for G0398 |
National average reimbursement for HCPCS G0398 by major payers:
$190.93
BCBS / Anthem
$246.55
UnitedHealthcare
$236.37
Aetna
$213.81
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for HCPCS G0398.
HCPCS G0398
5 of 25 sample ratesHigher to lower in this preview
Emory University, Emory University Hospital
Emory University
$540.96Published rateNavicent Health Oconee, LLC, Navicent Health Baldwin
Navicent Health Oconee LLC
$219.88Published rateBrooks County Hospital
$147.82Published rateFloyd Healthcare Management Inc, Atrium Health Floyd Medical Center
Floyd Healthcare Management, Inc.
$101.27Published rateEmory University Hospital
Emory University
$86.25Published rate
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Payer Contract Negotiation
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See a sample payer proposalHCPCS G0398 vs. Other Sleep Studies, In Home Codes
The table lists codes related to G0398. Select one to see its fee schedule.
| Code | Description |
|---|---|
| G0397-HCPCS | Alcohol and/or substance (other than tobacco) misuse structured assessment (e.g., audit, dast), and intervention, greater than 30 minutes |
| G0398-HCPCS | Home sleep study test (HST) with type II portable monitor, unattended; minimum of 7 channels: eeg, eog, emg, ecg/heart rate, airflow, respiratory effort and oxygen saturation |
| G0399-HCPCS | Home 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS G0398. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the G0398 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
What APC is HCPCS G0398 assigned to?
Medicare's hospital outpatient payment system (OPPS) assigns HCPCS G0398 to APC 5722 (Level 2 Diagnostic Tests and Related Services). An APC groups outpatient services that Medicare pays at the same base rate.
Which revenue codes are billed with HCPCS G0398?
Hospital price transparency files list HCPCS G0398 under these revenue codes: including 0519, 0740, 0920, 0929 and 0921. A revenue code names the hospital department or charge category for the line; it does not change what the service is.