Continuous Positive Airway Pressure (CPAP) therapy
Medicare Coverage Information
Overview
Medicare Part B covers Continuous Positive Airway Pressure (CPAP) therapy for patients diagnosed with sleep apnea. If you meet specific medical criteria, Medicare will help pay for CPAP machines, masks, and related supplies.
- Medicare covers CPAP therapy for patients diagnosed with sleep apnea
- Requires a doctor's prescription and documentation of medical necessity
- Covers rental of CPAP machine for first 13 months if used consistently
- Includes coverage for masks, tubing, and other necessary accessories
- Beneficiaries must meet specific diagnostic criteria
- Medicare Part B beneficiaries
- Patients with confirmed sleep apnea diagnosis
- Must have physician documentation of medical necessity
- Applicable for Original Medicare and some Medicare Advantage plans
- After Part B deductible, Medicare typically covers 80% of approved CPAP equipment costs
- Patients are responsible for 20% coinsurance
- Rental payments spread over 13 months for initial CPAP equipment
- Replacement supplies may have additional cost-sharing requirements
- Must have documented diagnosis of sleep apnea
- Requires compliance with usage requirements
- Coverage limited to medically necessary equipment
- Must obtain equipment from Medicare-approved suppliers
- Replacement equipment subject to additional documentation
- Consult with your healthcare provider about sleep apnea diagnosis
- Get a detailed prescription for CPAP therapy
- Contact Medicare-approved medical equipment supplier
- Verify specific coverage details with your Medicare plan
Last updated: 6/15/2025
Quick Information
- Provider
- Medicare
- Last Updated
- 6/15/2025
- Topics
- Medicare CPAP coveragesleep apnea treatmentMedicare medical equipmentCPAP device insuranceMedicare respiratory therapy
Related Coverage Topics
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