Local Coverage DeterminationNeurology

LCD L38307: Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea — CGS

LCD-L38307

Document details

Document type
Local Coverage Determination
Issuing body
MAC Contractor
Document ID
LCD-L38307
Published
June 5, 2026
Effective date
March 5, 2026
MAC region
CGS Administrators

Summary

The upcoming LCD on Hypoglossal Nerve Stimulation will affect billing practices for sleep apnea treatment services. Providers must ensure they are familiar with the guidelines to avoid claim denials o

New LCD impacts sleep apnea treatment billing.

Affected codes

ICD-10-CM

Affected specialty

Neurology alerts →

Source document

https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=38307&ver=14

CLV Intelligence summarizes publicly available federal publications. Not affiliated with or endorsed by any government agency.

Related alerts

4

FDA Approval: XEOMIN (INCOBOTULINUMTOXINA) — Type 1 - New Molecular Entity

Policy FDA-BLA125360 · Neurology

Critical

Xeomin (incobotulinumtoxinA) is an injectable botulinum toxin type A administered via injection, placing it squarely in the Medicare Part B pathway for physician-administered drugs. It is reimbursed u

View alert

FDA Approval: ENSPRYNG (SATRALIZUMAB) — Type 1 - New Molecular Entity

Policy FDA-BLA761149 · Neurology

High

Enspryng (Satralizumab) is an injectable drug approved for Part B billing, likely leading to a new J-code assignment. With its status as an orphan drug, it may qualify for pass-through payment under M

View alert

FDA Approval: EMGALITY (GALCANEZUMAB-GNLM) — Type 1 - New Molecular Entity

Policy FDA-BLA761063 · Neurology

High

Emgality (galcanezumab) is likely to receive a new J-code for billing under Medicare Part B since it is an injectable drug. The drug may be eligible for ASP+6% reimbursement, given its injectable stat

View alert

FDA Approval: VYEPTI (EPTINEZUMAB-JJMR) — Type 1 - New Molecular Entity

Policy FDA-BLA761119 · Neurology

High

VYEPTI (Eptinezumab-JJMR) is an injectable medication likely to receive a J-code for billing under Medicare Part B. Its category may allow for ASP+6% reimbursement, but billing teams should confirm th

View alert