If you've been diagnosed with sleep apnea, Medicare Part B may cover your CPAP machine and supplies — but there are rules. Here's what patients need to know before ordering equipment.

Who Qualifies for Medicare CPAP Coverage?

Medicare covers CPAP therapy when a doctor diagnoses you with obstructive sleep apnea (OSA) through a sleep study. The study must show at least 5 apneic or hypopneic episodes per hour of sleep.

Your doctor must provide a written order and clinical documentation before a supplier can bill Medicare. Without this, your claim will be denied.

What Does Medicare Part B Cover?

Medicare Part B covers:

  • CPAP machine rental — for the first 13 months, Medicare rents the equipment through a supplier
  • CPAP mask — one full face mask or nasal mask every 3 months if there's documented medical need
  • Mask cushions/pillows — two per month
  • Tubing — one per 3 months
  • Filters — two disposable filters per month; one non-disposable filter every 6 months
  • Headgear and chinstraps — one per 6 months
  • Humidifier — covered if medically necessary

The 13-Month Rental Rule

CPAP equipment follows Medicare's "capped rental" policy. For the first 13 months, Medicare pays the supplier to rent the equipment to you. After 13 months of continuous use, the equipment becomes yours — and Medicare switches to paying for ongoing supplies only.

What Do You Pay?

Once you've met your Part B deductible ($257 in 2025), Medicare pays 80% of the approved amount. You pay the remaining 20%. If you have a Medigap supplemental plan, it typically covers that 20%.

The 90-Day Trial Requirement

Medicare requires suppliers to conduct a face-to-face re-evaluation at the end of a 90-day trial period. During this time, you must show the CPAP is actually being used — typically at least 4 hours per night for at least 70% of nights over a 30-day period. If compliance data shows insufficient use, Medicare will stop covering the equipment.

Finding an Accredited CPAP Supplier

Medicare requires CPAP suppliers to be enrolled in Medicare and accredited by a CMS-approved accreditation organization. Buying from a non-accredited supplier means Medicare won't pay — and you'll owe the full cost.

When searching for a CPAP supplier:

  • Confirm they accept Medicare assignment (you pay only 20%)
  • Verify their NPI number
  • Ask about their accreditation status
  • Confirm they handle prior authorization paperwork

Bottom Line

Medicare covers CPAP and supplies for most sleep apnea patients — but the process has real requirements. Work with an accredited supplier who knows Medicare's rules, keep up with your prescribed therapy for the compliance check, and make sure your doctor's documentation is in order before equipment is ordered.