Does Medicare Cover a CPAP?
Yes — Medicare Part B covers a CPAP machine for obstructive sleep apnea after a qualifying sleep study and a 3-month trial period. The machine is rented for 13 months; after that, it's yours.
Who qualifies
- You've been diagnosed with obstructive sleep apnea (OSA) on a Medicare-approved sleep study.
- Your AHI (Apnea-Hypopnea Index) is 5–14 with documented symptoms, or ≥15 regardless of symptoms.
- Your doctor has prescribed CPAP and conducted a face-to-face evaluation.
- You complete a 3-month trial showing benefit and adherence (≥4 hours of use per night on 70% of nights in any 30-day window).
Qualifying conditions
- Obstructive sleep apnea (most common qualifying diagnosis)
- Central sleep apnea (covered with additional documentation)
- Complex sleep apnea
What it costs
- After the Part B deductible, you pay 20% coinsurance on the rental.
- Medicare rents the machine for 13 months — ownership transfers afterward.
- Supplies (mask, tubing, filters) ship on a recurring schedule and are also covered at 20% coinsurance.
- If you don't meet the 3-month adherence requirement, Medicare stops paying and you may need a new sleep study to requalify.
Check if you qualify
Step 1 of 2Takes about 60 seconds. We'll show you what your plan covers and connect you with a supplier if you qualify for CPAP.
Prior authorization timeline
Most CPAP claims do not require formal prior authorization, but a Medicare supplier must collect and retain documentation upfront to avoid claim denial.
Frequently asked
Do I need a sleep study to get a CPAP through Medicare?
Yes — either an in-lab polysomnogram or a Medicare-approved home sleep test (HST). The test must show qualifying AHI thresholds. Your doctor orders it.
What is the 90-day adherence rule?
During the first 90 days, your CPAP records data on usage. To continue Medicare coverage past day 90, you must use the device at least 4 hours per night on 70% of nights in any consecutive 30-day window. Your doctor must document benefit at a follow-up visit.
Will Medicare cover a BiPAP or APAP instead of a CPAP?
APAP (auto-adjusting CPAP) is billed under the same code (E0601) and is covered identically. BiPAP / RAD devices fall under different codes (E0470, E0471) and require additional documentation — typically failure of CPAP first, or specific neuromuscular/lung diagnoses.
How often does Medicare replace CPAP supplies?
Replacement schedules: masks every 3 months, tubing every 3 months, disposable filters every 2 weeks, full face cushions every 2 weeks, and a humidifier reservoir every 6 months. Your supplier ships on this cadence with your standing order.