The introduction of the national coverage determination created expanded opportunities in sleep medicine for diagnostic testing companies to provide OCSTs for the diagnosis of OSA. Many of the purveyors of diagnostic services provide no indication of state licensure and undiscerned training in sleep medicine. In addition, there is an absence of a clinical evaluation of the patient, and in many models it is unknown if the interpreting physician has access to raw data from the test to review. It is very realistic that patients with OSA, a chronic disease, are diagnosed without a sleep-related evaluation conducted by a specialized clinician. OCSTs present an additional challenge, as fewer channels for testing means limited data for the interpreting physician to review and make a sound clinical decision. The complexity of data interpretation for pulmonary function testing, chest radiographs, ECGs, and stress tests all involve specialized physicians, such as pulmonologists, cardiologists, and radiologists, in the diagnosis of the disease. Similarly, limited channels and fewer data for the diagnosis of OSA call for the clinical acumen and expertise of a BCSMP.