A Guide to Medicare Coverage of CPAP Machines and Supplies in 2024

Sep 11, 2023
Fact Checked
Read a full explanation of Medicare coverage of CPAP machines and related accessories.

Key Takeaways

More than 29 million Americans experience poor sleep quality due to obstructive sleep apnea (OSA), but only about 20% of those people have been diagnosed, according to the American Academy of Sleep Medicine.1 The idea that treatment will be expensive and not covered by insurance is one barrier that prevents people from diagnosis and seeking care, according to a study in the Journal of Clinical Sleep Medicine.2 Despite this perception, Medicare and most private insurance companies offer some degree of coverage for CPAP (continuous positive airway pressure) therapy, which includes CPAP machines and supplies and is a highly effective treatment for managing sleep apnea.3 In fact, when our Reviews Team surveyed 600 CPAP users in July 2023, 28.5% of respondents used Medicare, Medicare Part B, or Medicare Advantage to help pay for a CPAP machine. Another 28.33% used private insurance, while the remaining 43.17% used no insurance to pay for their equipment. This article discusses how and when Medicare covers CPAP therapy for first-time patients as well as how to replace your CPAP machine and supplies using Medicare.

Does Medicare cover CPAP machines?

The first thing to know about CPAP therapy and Medicare coverage is that the amount you’ll pay varies depending on the type of Medicare coverage you have and whether you have met your deductible. CPAP machines and other accessories are covered under durable medical equipment (DME).4

Table 1 Comparing different Medicare enrollment options, as of July 2023

What is it?Deductible amount**Copayment of the Medicare-approved amount (patient’s responsibility)Is DME (including CPAP) covered?
Original Medicare
(Medicare Part A)
Also called “hospital insurance.” Provides coverage for hospital stays, nursing facility care, hospice, and some home health care.$1,600 20%Part A covers DME that’s needed during hospital stays or while in short-term nursing facility care, hospice, and other home health care.
Original Medicare
(Medicare Part B*)
Also called “medical insurance.” Covers certain services, outpatient care, medical supplies, and preventive services.$226 20%Part B covers DME that’s needed for personal in-home use.
Medicare AdvantagePlans offered by private insurance carriers that have contracts with the federal government and agree to provide hospital, medical, and usually drug insurance adhering to coverage rules that Medicare sets.Depends on the private insurance carrier you chooseDepends on the private insurance carrier you chooseMedicare Advantage must provide the same coverage as Medicare for DME.

* CPAP machines and other supplies fall under Medicare Part B.

** Deductible for the 2023 year (deductible changes annually starting Jan. 1, or whenever your plan year begins). For Part A, the deductible is for each inpatient period, not the year.

When does Medicare cover CPAP machines?

Original Medicare Part B will only cover your CPAP therapy devices and accessories if, after a diagnostic sleep study, your prescribing doctor and the CPAP equipment supplier are enrolled in Medicare.5 Doctors and supplies enrolled with Medicare agree to accept the Medicare-approved amount for the service or product provided. This is called “accepting assignment.”

At times, the Medicare-approved amount may be less than the amount the provider would normally charge, but the provider agrees to accept the set amount as full payment for services. If your doctor or supplier doesn’t agree to be paid by Medicare directly, you’ll be responsible for the total cost of your CPAP supplies at the time of purchase.

If you have Medicare Advantage, coverage of DME varies by plan. Your plan may have specific rules about getting approval, selecting a brand, and choosing a supplier that you must follow to get coverage. Reach out to your plan for more information before ordering your CPAP supplies.

How does Medicare coverage work for CPAP machines?

After you’ve confirmed that your doctor and the supplier are enrolled and you’ve paid the $226 deductible, Medicare Part B will cover a three-month trial of CPAP therapy. This includes the machine and accessories, like tubing, filters, and masks.

To qualify for the three-month CPAP therapy trial, you must:

After the three-month trial period, Medicare pays 80% of the Medicare-approved amount to rent the machine for 13 months. You pay the remaining 20% as coinsurance. Medigap plans and other supplemental health insurance plans often cover the 20% copay. Following the 13-month CPAP machine rental, you’ll own it.

To qualify for the 13-month CPAP equipment rental (and ultimate purchase), you must:

You’ll need to use the CPAP machine without interruption throughout the 13-month rental period for Medicare to continue paying each month. If at any point you stop using the machine on a regular basis, Medicare can stop paying the rental, and you’ll need to return the machine to the supplier or pay the remaining balance in full.

Medicare CPAP documentation and compliance requirements

Medicare pays for the three-month trial period but will only rent and eventually pay for the machine if you follow compliance and documentation standards.7 The compliance period starts 31 days after starting CPAP therapy but must begin before day 90 of therapy (so between days 31 and 89 of therapy). During this period, you must meet with your doctor in person, and they must document that you have been adhering to therapy and it has helped you.

Adherence to therapy is defined as using your machine at least four hours per day for 70% of days. For example, if you use your CPAP machine for four hours per night for 22 days out of 30 days, you’ve adhered to therapy and are compliant. Anything less than that is considered non-compliant. If you’re not compliant, your doctor will report it, and Medicare will deny your CPAP coverage. If you want to try to qualify for coverage again, you’ll have to repeat the trial qualification process.

CPAP machines will automatically transmit usage data to your CPAP supplier and, upon request, your prescriber and insurance company. Depending on your machine, this information can also be available using a smartphone app, so you can access and track your sleeping data as well.

Patients currently using a CPAP who become Medicare patients

If you’re currently using CPAP therapy and you’re new to Medicare, you might be able to qualify for CPAP machine and accessory replacements. To meet eligibility, you must have a sleep study on record that meets the Medicare qualifications for new CPAP users (positive diagnosis of OSA with threshold AHI or RDI events per minute or symptoms), and your enrolled physician must confirm and document that CPAP use helps you.8

Does Medicare cover CPAP supplies?

Medicare covers accessories, like tubing, filters, humidification chambers, and CPAP masks. The same rules that apply to machines, including travel CPAP machines, apply to these items as well. For Original Medicare to cover your items, the supplier must be enrolled with Medicare, and you’ll be responsible for a 20% copayment. Most supplies are also eligible for regular replacement, so long as the frequency matches the Medicare guidelines.

Does Medicare cover replacement supplies?

If you’re a current CPAP user who is new to Medicare, you can get your equipment replaced if you qualify under the new CPAP patient guidelines and your equipment is due for replacement under the Medicare standards.9 If you’re a new CPAP patient, you can replace your supplies as frequently as Medicare suggests.

Table 2: Medicare guidelines for replacing common CPAP equipment

SuppliesReplacement frequency
Tubing1 every 3 months
Combination oral/nasal CPAP mask1 every 3 months
Oral cushion for combination oral/nasal mask (pair)2 every month
Full face mask1 every 3 months
Face mask interface for full face mask1 every month
Nasal interface (mask or cannula type)1 every 3 months
Cushion for nasal mask interface2 every month
Nasal pillows2 every month
Disposable filter2 every month
Non-disposable filter1 every 6 months
Humidifier water chamber1 every 6 months
Headgear1 every 6 months
Chinstrap1 every 6 months
CPAP machine*1 every 5 years

* Medicare only covers replacement after you’ve reached the estimated lifetime (five years for DME).10 Until then, Medicare will pay for repairs needed to meet that lifetime (which may include total replacement).

What are the best CPAP machines?

CPAP machines come in many varieties and brands based on the sleeper’s unique needs. The three main types of machines are:

Your doctor will prescribe you a machine type based on your sleep lab results and common sleeping positions. They range in price from around $500–$1,000 or more. We’ve researched dozens of brands of CPAP machines based on quality, affordability, and reliability. Additionally, CPAP machines require a mask for use, so consider what CPAP mask might be best for you.

Bottom line

Before Medicare will cover the cost of your CPAP machine and accessories, you must be diagnosed with obstructive sleep apnea by a Medicare-enrolled doctor, which requires an overnight sleep study. Your device and accessories must come from a Medicare-enrolled supplier. If you used a CPAP machine before getting Medicare and you meet certain requirements, your replacement machine and accessories may be covered. If you qualify for coverage, Medicare doesn’t pay the total cost for your CPAP machine upfront. Instead, Medicare pays 80% of the rental payment cost for 13 months, which gives you ownership of the machine.

Frequently asked questions

No. Medicare doesn’t cover the full CPAP machine cost. Medicare will cover 80% of the approved amount to rent the machine for 13 months. You will pay the remaining 20%. After meeting compliance guidelines for using the machine during the rental period, it will be paid in full and will belong to you.

Medicare pays for 80% of the cost to rent a CPAP machine from a Medicare-enrolled supplier, and you are responsible for the remaining 20%.

Medicare will pay to replace your CPAP machine once every five years. If your machine breaks before the five-year mark, Medicare will pay the cost to repair the machine (which may include the cost of a total replacement).

Yes, Medicare Part B pays for CPAP machines after you pay the $226 deductible.

A Medicare-approved doctor must document an OSA diagnosis through a sleep study. To qualify for a three-month CPAP therapy trial, you must have an AHI or RDI of at least 15 events per hour, or five to 14 events per hour combined with other documented symptoms (like heart disease, hypertension, or excessive daytime sleepiness). Your doctor must document your CPAP therapy adherence and confirm its effectiveness for you to qualify for a 13-month CPAP equipment rental (and ultimate purchase).

Have questions about this review? Email us at reviewsteam@ncoa.org.


  1. American Academy of Sleep Medicine. Hidden Health Crisis Costing America Billions. Aug. 8, 2016. Found on the internet at https://aasm.org/resources/pdf/sleep-apnea-economic-crisis.pdf
  2. Journal of Clinical Sleep Medicine. Facilitators and barriers to getting obstructive sleep apnea diagnosed: perspectives from patients and their partners. March 1, 2022. Found on the internet at https://jcsm.aasm.org/doi/10.5664/jcsm.9738
  3. American Lung Association. Treating and Managing Sleep Apnea. Found on the internet at https://www.lung.org/lung-health-diseases/lung-disease-lookup/sleep-apnea/treating-and-managing
  4. Centers for Medicare & Medicaid Services. Medicare Coverage of Durable Medical Equipment & Other Devices. Found on the internet at https://www.medicare.gov/media/publication/11045-medicare-coverage-of-dme-and-other-devices.pdf
  5. Medicare.gov. Search for Medical Equipment & Suppliers. Found on the internet at https://www.medicare.gov/medical-equipment-suppliers/
  6. Centers for Medicare & Medicaid Services. Continuous Positive Airway Pressure (CPAP) Therapy For Obstructive Sleep Apnea (OSA). Found on the internet at https://www.cms.gov/medicare-coverage-database/view/ncd.aspx?ncdid=226
  7. Centers for Medicare and Medicaid Services. Medicare Quarterly Provider Compliance Newsletter: Guidance to Address Billing Errors. April 2021. Found on the internet at https://www.cms.gov/files/document/medicare-quarterly-provider-compliance-newsletter-volume-11-issue-3-print-friendly.pdf
  8. University of Michigan Health. Medicare and CPAP Compliance. Found on the internet at https://www.uofmhealth.org/conditions-treatments/brain-neurological-conditions/medicare-and-cpap-compliance
  9. Department of Health and Human Services. Replacement Schedules for Medicare Continuous Positive Airway Pressure Supplies. June 2013. Found on the internet at https://oig.hhs.gov/oei/reports/oei-07-12-00250.pdf
  10. Medicare Interactive. Replacing DME. Found on the internet at https://www.medicareinteractive.org/get-answers/medicare-covered-services/durable-medical-equipment-dme/replacing-dme
  11. CPAP Survey. 600 respondents. Conducted using Pollfish. Launched July 25, 2023.
Miranda Riva is a writer and licensed Tennessee attorney who has written and edited legal content covering the topics of family law, business law, criminal law, environmental law, and estate law.
Elizabeth Lyda headshot
Elizabeth U. Lyda Medical Reviewer
Elizabeth Lyda, RRT, holds a bachelor of science degree from Empire State College and associate of science degree with a certificate in Respiratory Care from Mansfield State University, and has been a respiratory therapist since 1983. She was named Respiratory Therapist of the Year in 2007 from the University of Rochester and remains licensed in the state of New York.
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