Can You Get Insurance Using CPAP Treatment For Sleep Apnea?
For people that follow sleep apnea treatment, CPAP treatment insurance is a must. Obstructive sleep apnea is a chronic and lifelong condition that requires treatment. Not only will you require a CPAP machine, you will also need CPAP supplies, accessories and other essentials to help battle your sleep disorder. There are a number of insurance companies that cover CPAP treatment costs. You may have to pay for the costs up front and then get reimbursed by the insurance company. Associated costs that may be recovered include the following:
- Cost for a sleep study
- Diagnosis of Obstructive Sleep Apnea
- Prescription costs from your physician
- Cost for CPAP machine and accessories
Most insurance companies will cover the cost for a physician-referred sleep study. While sleep studies have traditionally been performed in a sleep lab during an overnight stay, many other insurance companies now also pay for in-home sleep studies used to diagnose Obstructive Sleep Apnea (OSA).
It is important to contact your insurance company beforehand to determine if they will cover the cost for an in-lab or in-home sleep study and to understand any deductible or co-payment amounts that you may be responsible for. Your insurance company will also be able to assist you in understanding what other costs are covered, what documentation is required from you, and what, if any financial responsibility you may have.
What are the codes my insurance requires when I make a CPAP-related purchase?
The HCPCS (Healthcare Common Procedure Coding System) Code Set is one of the standard code sets used for the purposes of Medicare and other health insurance programs to ensure that these claims are processed in an orderly and consistent manner.
Insurance companies often require a product code called a HCPCS code for claims related to your CPAP purchases. Below is a detailed list of codes your insurance company may need to quickly process your claim. Please note that every insurance company is different and may not accept HCPCS codes for CPAP related equipment. We have provided a list of HCPCS codes below for your reference. It is important to note that not all CPAP equipment is eligible for insurance reimbursement so discuss this with your insurance company.
I will point out that I don’t know if all insurance companies in different countries adhere to this list of codes. I am providing this list of codes for information purposes only. Please check with your own insurance company regarding coverage levels.