CPAP HCPCS Codes

 In CPAP Insurance, Most Popular Posts, Sleep Apnea

Are you curious whether or not your CPAP supplies are covered by insurance?  Look no further, as Health Sqyre is here to help!  Any CPAP supply item covered by insurance will have a Healthcare Common Procedure Coding System (HCPCS), or CPAP HCPCS, number.  Moreover, each ‘category’ of CPAP products has its own reimbursement schedule.  You should utilize this schedule correctly with your current insurance plan to save you tons of money!

The following table shows Medicare’s reimbursement schedule.  Most major insurance companies, such as Aetna, Blue Cross Blue Shield (BCBS), Humana, and more will follow this schedule:

List / Schedule of CPAP HCPCS Codes

Code Description

CPAP HCPCS

Usual Maximum

Heated TubingA46041 per 3 months
Hybrid MaskA70271 per 3 months
Replacement Hybrid Mask CushionA70282 per 1 month
Replacement Hybrid Mask Nasal PillowA70292 per 1 month
Full Face MaskA70301 per 3 months
Replacement Full Face Mask CushionA70311 per 1 month
Replacement Nasal Mask CushionA70322 per 1 month
Replacement Nasal PillowA70332 per 1 month
Nasal Pillow MaskA70341 per 3 months
HeadgearA70351 per 6 months
ChinstrapA70361 per 6 months
TubingA70371 per 3 months
Disposable FilterA70382 per 1 month
Non-disposable FilterA70391 per 6 months
Oral Interface MaskA70441 per 3 months
Replacement Humidifier ChamberA70461 per 6 months
BiPAP MachineE04701 per 5 years
BiPAP Auto MachineE04711 per 5 years
Non-heated CPAP HumidifierE05611 per 5 years
Heated CPAP HumidifierE05621 per 5 years
CPAP MachineE06011 per 5 years


Pro tip: If you have any questions about how specific aspects of insurance, like deductibles, co-insurance rates, etc., 
check out Health Sqyre’s Guide to Insurance.

 

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