CPAP Replacement Schedules

Home » Sleep & Respiratory » CPAP Replacement Schedules

    

CPAP SUPPLY REPLACEMENT SCHEDULE 

 Medicare  

 

                                     Max allowable

Code                        Description                                                      replacement____

A7029                Nasal pillows for A7027                             2 per month

A7031                Replacement cushion - full face mask       1 per month         

A7032                Nasal mask cushion                                  2 per month

A7038                Disposable filter                                          2 per month

A7033                Nasal pillows                                              2 pair per month

A7028                Oral Cushion for A7027                              2 per month

A7034                Nasal interface                                           1 per 3 mos

A7037                Tubing                                                        1 per 3 mos

A4605                Heated tubing                                             1 per 3 mos

A7030                Full Face Mask                                          1 per 3 mos

A7027                Oral/Nasal Combo mask                            1 per 3 mos

A7035                Headgear for any type Interface                1 per 6 mos

A7036                Chinstrap                                                   1 per 6 mos

A7039                Non-disposable filter                                 1 per 6 mos

A7046                Replacement water chamber                    1 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

 

Code                    Description                                      Maximum allowable replacement

 

A7027                        Oral/Nasal Combo mask                 Once every 6 months

A7028                        Oral Cushion for A7027                 Once every 6 months

A7029                        Nasal pillows for A7027                  Once every 6 months

A7030                        Full Face Mask                                 Once every 5 years

A7031                        Replacement cushion                    Once every 6 months

                                     -For full face mask

A7032                        Nasal mask cushion                         Once every 6 months

A7033                        Nasal pillows                                    Once every 6 months

A7034                        Nasal interface                                Once every 5 years

A7035                        Headgear                                        Once every 6 months

                                    -For any type of Interface       

A7036                        Chinstrap                                          Once every 6 months

A7037                        Tubing                                              Once every 6 months

A4604                        Heated tubing                                   Not covered

A7038                        Disposable filter                               Two per month

A7039                        Non-disposable filter                       Two 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.  

 

Online Bill Pay

Qualify through insurance for a free breast pump. Call us for details. Rome: (315) 339-4084. Syracuse: (315) 475-5181.

Hours
Rome
M-F8:30 a.m.5:00 p.m.
Sat9:00 a.m.1:00 p.m.
SunClosed
Syracuse
M, W-F8:30 a.m.5:00 p.m.
Tuesday8:30 a.m.6:00 p.m.
Sat9:00 a.m.1:00 p.m.
SunClosed

Live Customer Service

Certified Women Owned Business

NYMEP - New York Medical Equipment Providers Association

The VGM Group

The Med Group

achc logo