What are the Medicare requirements for CPAP coverage?
Quick Answer
Medicare Part B covers CPAP equipment when you meet these requirements: 1) A face-to-face evaluation with your doctor documenting sleep apnea symptoms. 2) A qualifying sleep study (in-lab or home test) showing an AHI of 5 or higher. 3) A prescription from your treating physician. 4) Initial 90-day t...
Medicare Part B covers CPAP equipment when you meet these requirements: 1) A face-to-face evaluation with your doctor documenting sleep apnea symptoms. 2) A qualifying sleep study (in-lab or home test) showing an AHI of 5 or higher. 3) A prescription from your treating physician. 4) Initial 90-day trial period to demonstrate CPAP usage of at least 4 hours per night on 70% of nights. After meeting compliance requirements, Medicare covers 80% of the approved amount for CPAP rental and supplies. You pay 20% plus any unmet Part B deductible.
More Information
Medicare covers CPAP with a sleep study, doctor prescription, and demonstrated therapy compliance during a 90-day trial.
Medical Disclaimer
The information provided in this article is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before making any decisions about your health or treatment.
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