Health Complex Logo 

Home Oxygen & Sleep Specialists
Your Health . . . Our Concern . . . At Home
Serving Connecticut for over 20 years
Toll Free Phone: 1.888.575.7778
Toll Free Fax: 1.800.221.3003

Medicare CPAP Coverage Guidelines

Initial Coverage
Patient must have a diagnosis of Obstructive Sleep Apnea (OSA) documented by an attended, facility-based polysomnogram
AND
Meet either of the following criteria:
* AHI (Apnea-Hypopnea Index) is greater than or equal to 15 events per hour,
OR
* AHI is from 5 to 14 events per hour with documented symptoms of:
(a) Excessive daytime sleepiness, impaired cognition, mood disorders, or insomnia
OR
(b) Hypertension, ischemic heart disease, or history of stroke.

Continued Coverage
Effective with dates of service on or after July 1, 2002, continued coverage of a CPAP beyond the first three months of therapy requires documentation from the patient or the treating physician that the Medicare beneficiary is continuing to use the CPAP device.

Proudly Accredited by
Click here to visit The Joint Commission

Website © Copyright 2008
All rights reserved.

Any reproduction of this site or any of its contents
without written permission is prohibited.

An affiliate of
Click here to visit The Med Group