CPAP Replacement Schedules

CPAP SUPPLYREPLACEMENT SCHEDULE 

Medicare

Max allowable

Replacement cushion - full face mask Headgear for any type Interface

CodeDescriptionReplacement
A7029Nasal pillows for A70272 per month
A7031Replacement cushion - full face mask1 per month
A7032Nasal mask cushion2 per month
A7038Disposable filter2 per month
A7033Nasal pillows2 pair per month
A7028Oral Cushion for A70272 per month
A7034Nasal interface1 per 3 mos
A7037Tubing1 per 3 mos
A4605Heated tubing1 per 3 mos
A7030Full Face Mask1 per 3 mos
A7027Oral/Nasal Combo mask1 per 3 mos
A7035Chinstrap1 per 6 mos
A7036Chinstrap1 per 6 mos
A7039Non-disposable filter1 per 6 mos
A7046Replacement water chamber1 per 6 mos


The above schedule is specific to Medicare insurance; however, many other insurance companies follow this same schedule for CPAP supplies.  


CPAP SUPPLY REPLACEMENT SCHEDULE 

Medicaid


CodeDescriptionMaximum allowable replacement
A7027Oral/Nasal Combo maskOnce every 6 months
A7028Oral Cushion for A7027Once every 6 months
A7029Nasal pillows for A7027Once every 6 months
A7030Full Face MaskOnce every 5 years
A7031Replacement cushionOnce every 6 months

-For full face mask
A7032Nasal mask cushionOnce every 6 months
A7033Nasal pillowsOnce every 6 months
A7034Nasal interfaceOnce every 5 years
A7035HeadgearOnce every 6 months

-For any type of Interface
A7036ChinstrapOnce every 6 months
A7037TubingOnce every 6 months
A4604Heated tubingNot covered
A7038Disposable filterTwo per month
A7039Non-disposable filterTwo every 6 months


*A prescription is needed for any supplies that are billed through insurance.* 


We strongly suggest you call ahead to ensure we have your supplies in stock and to update your insurance information.