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How to Bill Your Health Insurance for Your Out-of-Pocket CPAP Expenses

Many of our customers have requested information from us in reference to submitting a health insurance claim for supplies bought through CPAP Supply USA. To help our patients use their insurance to their fullest benefit, we have decided to include this page of general instructions for filing an insurance claim on your own behalf for CPAP and BiPAP supplies. Please Note: Medicare does not allow patients to submit claims on their own behalf. These claims must be billed from a medical equipment company with a Medicare provider number.

Please Note: CPAP Supply USA can only provide general instructions for our patients. We cannot determine the policies and procedures for each insurance company and therefore cannot guarantee that this information is accurate for your specific policy. Please verify the following information with your company prior to filing a claim.

General Instructions

  • Contact the members services department of your insurance company directly to ensure that they allow subscribers to submit claims for medical expenses purchased out-of-pocket (such as the CPAP supplies you purchased through CPAP Supply USA).
  • When speaking with the representative from your insurance, ask them on what type of form they require you to submit your claim information. Some companies will allow you to use a generic document called the Health Insurance Claim Form . You can download this form here .
  • Complete the form required, including the billing and qualifying information used by insurance companies to process claims (see below: HCPCS codes, Diagnosis Codes, and Tax ID numbers).
  • Attach a copy of your invoice from CPAP Supply USA. Supplies ordered on your invoice will need to be split into the appropriate HCPCS billing codes based on your purchases.
Example: Our CPAP masks generally come with headgear. Insurance companies process the cost of mask headgear and the mask separately. When you send your invoice you will need to make these separations. As a general rule, the cost of your mask alone is 70% of the total cost you paid, while the headgear is 30% of the total cost. Using this general rule will allow you to split these

costs into the correct codes for your insurance company.

  • Submit the claim form and invoice to your insurance company in the method they prescribe (most require you mail; some will allow you to fax).
  • Wait for reimbursement. Generally, insurance companies say they can complete claims within 30 business days. Check with your company for their specific turnaround time.
  • Required Billing Codes

    HCPCS Billing Codes

    The following HCPCS codes are used by insurance companies to process claims. Please use the appropriate code on your claim form to ensure timely processing. Codes should correspond to each separate item on your invoice. Please Note: Items such as CPAP bed pillows, batteries, and DC adapters are not covered as they are considered luxury items.

    E0601 - CPAP machine purchase

    A7034 - CPAP nasal mask

    A7032 - CPAP nasal mask cushion

    A7030 - CPAP Full Face mask

    A7031 - CPAP Full Face mask cushion

    A7046 - CPAP Humidifier Chamber

    A7037 - CPAP tubing, long and short hoses

    A7038 - CPAP disposable filter

    A7033 - CPAP nasal pillows

    A7036 - CPAP chinstrap

    E0561 - CPAP Passover Humidifier

    E0562 - CPAP Heated Humidifier

    E0470 - BiPAP purchase

    E0471 - BiPAP-ST purchase

    A4604 - Thermo Smart Tube

    K0553 - Oral/Nasal (Hybrid) Mask

    K0554 - Oral Cushion for Hybrid Mask

    K0555 - Nasal Cushion for Hybrid Mask

    E1399 - CPAP Miscellaneous (this code is to be used for any CPAP items covered by your insurance but not listed above.

    Physician Diagnosis Code

    Insurance companies require you provide a code associated with your specific medical diagnosis. The diagnosis code for Obstructive Sleep Apnea is 327.23. To ensure that you have the correct code for your diagnosis, contact your physician.

    Our Company Information

    Your insurance company may require information about CPAP Supply USA, INC to process your claim. The most requested information is below:

    CPAP Supply USA, LLC

    413 Branchway Road Ste B

    Chesterfield, VA 23236

    Phone: 866.560.2727

    Fax: 866.560.4227

    Tax ID Number: 45-4231828

    Category: Insurance

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