Continuous Positive Airway Pressure (CPAP) Therapy For Obstructive Sleep Apnea (OSA)

Medicare covers CPAP for adult patients with obstructive sleep apnea (OSA) when diagnosis is by attended PSG or an unattended Type II/III/IV home sleep test (Type IV must measure >=3 channels) and AHI/RDI thresholds are met (>=15 events/hr, or 5–14 events/hr with qualifying symptoms or comorbidities). Coverage is limited to an initial 12-week trial during which the beneficiary must demonstrate benefit; providers must document the sleep test, AHI/RDI calculations, physician order/supervision, and beneficiary education. Limited additional coverage is available under CED for beneficiaries who do not meet standard criteria only when CPAP is provided as part of qualifying clinical studies that meet specified CMS research standards.

"CPAP therapy is covered for adult patients with obstructive sleep apnea (OSA)."

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