July 9, 2008
Continuous positive airway pressure therapy for obstructive sleep apnea
Effective date: March 13, 2008
Implementation date: August 4, 2008
Summary
Medicare previously covered the use of continuous positive airway pressure (CPAP) therapy only in beneficiaries:
• Who had been diagnosed with moderate to severe obstructive sleep apnea (OSA)
• When ordered and prescribed by a licensed treating physician
• Confirmed by polysomnography (PSG) performed in a sleep laboratory in accordance with section 240.4 of the Medicare NCD Manual
Following the reconsideration of its coverage policy, CMS is revising the existing national coverage determination (NCD) on CPAP therapy for OSA as well as allowing coverage of CPAP based on a positive diagnosis of OSA by HST, subject to all the requirements of the new NCD, as outlined in CR 6048.
.Source: CMS MLN Matters Article MM6048
