Sleep Studies

Resources

Starting Nov. 3, 2025, Blue Cross Blue Shield of Michigan and Blue Care Network will manage in-lab sleep studies for most commercial members. For more information, see In-lab sleep studies managed by Blue Cross and BCN: Frequently asked questions for providers.

Sleep studies have the following utilization management requirements:

Setting	Details
Home	For Blue Care Network commercial members in the East and Southeast regions, submit plan notification to BCN through the e-referral system to facilitate claims payment (clinical review isn't needed). See the BCN Prior Authorization & Plan Notification page for additional information. Important: Only providers who have signed a specific sleep testing agreement may provide sleep management services to BCN members. To identify home sleep study providers, use our online provider search on the Find Care page on bcbsm.com.
In lab	For Blue Cross Blue Shield of Michigan commercial members, submit prior authorization requests to Carelon Medical Benefits Management for: All fully insured groups and all individual members Most self-funded groups Includes UAW Retiree Medical Benefits Trust non-Medicare members For exceptions, see the Carelon exclusion list for Blue Cross Blue Shield of Michigan commercial The requirements outlined above don't apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714).
For BCN commercial members: Submit prior authorization requests to Carelon. Important: Only providers who have signed a specific sleep testing agreement may provide sleep management services to BCN members.

Setting

Details

Home

For Blue Care Network commercial members in the East and Southeast regions, submit plan notification to BCN through the e-referral system to facilitate claims payment (clinical review isn't needed).

See the BCN Prior Authorization & Plan Notification page for additional information.

Important: Only providers who have signed a specific sleep testing agreement may provide sleep management services to BCN members. To identify home sleep study providers, use our online provider search on the Find Care page on bcbsm.com.

In lab

For Blue Cross Blue Shield of Michigan commercial members, submit prior authorization requests to Carelon Medical Benefits Management for:

All fully insured groups and all individual members
Most self-funded groups

Includes UAW Retiree Medical Benefits Trust non-Medicare members
For exceptions, see the Carelon exclusion list for Blue Cross Blue Shield of Michigan commercial

The requirements outlined above don't apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714).

For BCN commercial members: Submit prior authorization requests to Carelon.

Important: Only providers who have signed a specific sleep testing agreement may provide sleep management services to BCN members.

How to submit prior authorization requests

To learn how to submit requests, see our Getting Started page.

Submit requests before providing services.

Utilization Management Criteria

Visit our Utilization Management Criteria page.

Carelon Medical Benefits Management is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.