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

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