Insurance Codes

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Does My Health Insurance Cover CPAP Therapy?

Virtually all health insurance plans now cover CPAP therapy for obstructive sleep apnea, though the exact terms vary from plan to plan. Coverage is generally split into two categories: the clinical side (sleep studies, physician visits, and any required specialist referrals) and the equipment side (your CPAP machine, mask, and ongoing supplies). Review your plan’s specific benefits, deductible, and copay requirements, or contact your insurance provider directly, to understand exactly what is covered before you purchase.

CPAP Machine Rental or Purchase?

Some insurance plans, including Medicare, require a rental period before you take ownership of your CPAP machine. Under Medicare, for example, you typically rent the device for 13 months of continued, compliant use before it becomes yours, and your deductible may reset during that rental period depending on when it falls in your plan year. Many private insurers, on the other hand, allow you to purchase your CPAP equipment outright and submit it for reimbursement right away.

Does Medicare & Medicaid Cover CPAP Therapy?

Medicare does cover CPAP therapy, but only when the equipment is supplied by a Medicare-approved Durable Medical Equipment (DME) provider. The CPAP Shop is not a Medicare-approved DME provider, so Medicare beneficiaries should purchase through an approved supplier if they plan to bill Medicare directly. Medicaid coverage for CPAP therapy varies by state, so check with your state’s Medicaid program for its specific rules and requirements.

Can I Bill Insurance for Reimbursement of CPAP Equipment Costs?

The CPAP Shop does not bill insurance companies directly. Instead, we provide a detailed invoice that you can submit to your insurance provider yourself for reimbursement. Your invoice includes the HCPCS billing codes for the products you purchased, which your insurer uses to process your claim — so it’s important that the codes on your invoice match what your plan expects. We recommend confirming your specific coverage and documentation requirements with your insurer before you file a claim.

Can I Use My Health Savings Account (HSA) or Flexible Spending Account (FSA) for CPAP Equipment?

Yes. We accept HSA and FSA funds for eligible CPAP equipment and supplies, as long as your HSA or FSA card is affiliated with a major credit card network. Simply use your HSA or FSA card at checkout the same way you would any other credit or debit card.

Can I Afford CPAP Therapy Without Insurance?

Yes — CPAP therapy is accessible even without insurance coverage. We offer discounted cash pricing designed for uninsured and high-deductible patients, so you can get the equipment you need without waiting on a claim. Flexible financing options are also available if you’d like to spread the cost over time.

What Are the Insurance Codes I Need to Submit for My CPAP Equipment?

If you’re submitting a claim for reimbursement, your insurer will ask for the HCPCS (Healthcare Common Procedure Coding System) codes that correspond to your equipment. Below are the codes commonly used for CPAP, BiPAP, and related respiratory equipment.

CPAP/BiPAP Devices

  • E0601 NU – CPAP device purchase
  • E0470 NU – BiPAP without back-up rate feature
  • E0471 NU – BiPAP with back-up rate feature

Masks and Interfaces

  • A7030 – Full face mask
  • A7031 – Full face mask cushion
  • A7034 – Nasal mask (mask or cannula type) for CPAP, with or without head strap
  • A7033 – Nasal pillows/seals, replacement parts for nasal interface, pair
  • A7044 – Oral interface for CPAP

CPAP Accessories

  • A7035 – Headgear for CPAP
  • A7036 – Chin strap for CPAP
  • A7037 – Tubing for CPAP
  • A7038 – Disposable filter, ultra fine
  • A7039 – Non-disposable filter, foam

Humidification

  • E0561 – Passover humidifier
  • E0562 – Heated humidifier
  • E7046 – Heated humidification chamber

Miscellaneous CPAP

  • E1399 – Miscellaneous durable medical equipment items
  • A9900 – Miscellaneous components of accessory items

Oxygen Delivery

  • A4615 – Nasal cannula
  • A4616 – Oxygen tubing
  • A4620 – Oxygen mask
  • A7015 – Aerosol mask
  • E0455 – Oxygen tent

Oxygen Concentrators

  • E0433 – Portable concentrator
  • E1390 – Oxygen concentrator (up to 5L)
  • QG1390 – Oxygen concentrator (up to 10L)

Oxygen Conservation/Regulation

  • E0424 – Oxygen-conserving device (Oxymizer)
  • E1353 – Regulators

Nebulizers and Humidification

  • A7004 – Disposable nebulizer kit
  • A7005 – Non-disposable nebulizer kit
  • E0570 – Nebulizer with compressor
  • E0575 – Ultrasonic nebulizer
  • E0580 – Nebulizer for humidification
  • E0555 – Humidifiers

Spacers

  • S8100 – Spacer without mask
  • S8101 – Spacer with mask

Insurers set their own reimbursement rates, and the codes and documentation on your invoice must match what your plan requires. Confirm coverage details with your insurance provider before filing a claim.
Does My Health Insurance Cover CPAP Therapy?

Virtually all health insurance plans now cover CPAP therapy for obstructive sleep apnea, though the exact terms vary from plan to plan. Coverage is generally split into two categories: the clinical side (sleep studies, physician visits, and any required specialist referrals) and the equipment side (your CPAP machine, mask, and ongoing supplies). Review your plan’s specific benefits, deductible, and copay requirements, or contact your insurance provider directly, to understand exactly what is covered before you purchase.
CPAP Machine Rental or Purchase?

Some insurance plans, including Medicare, require a rental period before you take ownership of your CPAP machine. Under Medicare, for example, you typically rent the device for 13 months of continued, compliant use before it becomes yours, and your deductible may reset during that rental period depending on when it falls in your plan year. Many private insurers, on the other hand, allow you to purchase your CPAP equipment outright and submit it for reimbursement right away.
Does Medicare & Medicaid Cover CPAP Therapy?

Medicare does cover CPAP therapy, but only when the equipment is supplied by a Medicare-approved Durable Medical Equipment (DME) provider. The CPAP Shop is not a Medicare-approved DME provider, so Medicare beneficiaries should purchase through an approved supplier if they plan to bill Medicare directly. Medicaid coverage for CPAP therapy varies by state, so check with your state’s Medicaid program for its specific rules and requirements.
Can I Bill Insurance for Reimbursement of CPAP Equipment Costs?

The CPAP Shop does not bill insurance companies directly. Instead, we provide a detailed invoice that you can submit to your insurance provider yourself for reimbursement. Your invoice includes the HCPCS billing codes for the products you purchased, which your insurer uses to process your claim — so it’s important that the codes on your invoice match what your plan expects. We recommend confirming your specific coverage and documentation requirements with your insurer before you file a claim.
Can I Use My Health Savings Account (HSA) or Flexible Spending Account (FSA) for CPAP Equipment?

Yes. We accept HSA and FSA funds for eligible CPAP equipment and supplies, as long as your HSA or FSA card is affiliated with a major credit card network. Simply use your HSA or FSA card at checkout the same way you would any other credit or debit card.
Can I Afford CPAP Therapy Without Insurance?

Yes — CPAP therapy is accessible even without insurance coverage. We offer discounted cash pricing designed for uninsured and high-deductible patients, so you can get the equipment you need without waiting on a claim. Flexible financing options are also available if you’d like to spread the cost over time.
What Are the Insurance Codes I Need to Submit for My CPAP Equipment?

If you’re submitting a claim for reimbursement, your insurer will ask for the HCPCS (Healthcare Common Procedure Coding System) codes that correspond to your equipment. Below are the codes commonly used for CPAP, BiPAP, and related respiratory equipment.

CPAP/BiPAP Devices

  • E0601 NU – CPAP device purchase
  • E0470 NU – BiPAP without back-up rate feature
  • E0471 NU – BiPAP with back-up rate feature

Masks and Interfaces

  • A7030 – Full face mask
  • A7031 – Full face mask cushion
  • A7034 – Nasal mask (mask or cannula type) for CPAP, with or without head strap
  • A7033 – Nasal pillows/seals, replacement parts for nasal interface, pair
  • A7044 – Oral interface for CPAP

CPAP Accessories

  • A7035 – Headgear for CPAP
  • A7036 – Chin strap for CPAP
  • A7037 – Tubing for CPAP
  • A7038 – Disposable filter, ultra fine
  • A7039 – Non-disposable filter, foam

Humidification

  • E0561 – Passover humidifier
  • E0562 – Heated humidifier
  • E7046 – Heated humidification chamber

Miscellaneous CPAP

  • E1399 – Miscellaneous durable medical equipment items
  • A9900 – Miscellaneous components of accessory items

Oxygen Delivery

  • A4615 – Nasal cannula
  • A4616 – Oxygen tubing
  • A4620 – Oxygen mask
  • A7015 – Aerosol mask
  • E0455 – Oxygen tent

Oxygen Concentrators

  • E0433 – Portable concentrator
  • E1390 – Oxygen concentrator (up to 5L)
  • QG1390 – Oxygen concentrator (up to 10L)

Oxygen Conservation/Regulation

  • E0424 – Oxygen-conserving device (Oxymizer)
  • E1353 – Regulators

Nebulizers and Humidification

  • A7004 – Disposable nebulizer kit
  • A7005 – Non-disposable nebulizer kit
  • E0570 – Nebulizer with compressor
  • E0575 – Ultrasonic nebulizer
  • E0580 – Nebulizer for humidification
  • E0555 – Humidifiers

Spacers

  • S8100 – Spacer without mask
  • S8101 – Spacer with mask

Insurers set their own reimbursement rates, and the codes and documentation on your invoice must match what your plan requires. Confirm coverage details with your insurance provider before filing a claim.