How to Receive Reimbursement for CPAP Expenses From Your Health Insurance Provider

GoCPAP does not bill private insurance companies directly for the cost of your CPAP supplies. However, you can submit a request for reimbursement to your insurance company to recover your out-of-pocket costs. To help with this process, we've outlined instructions below for filing an insurance claim on your own behalf for both CPAP and BiPAP supplies.

Note: Medicare recipients cannot submit reimbursement claims on their own behalf. All Medicare claims must be billed from an equipment company that holds a Medicare provider number. See our Medicare Notice for more information.

Also note: We can only provide basic instructions on how to submit a reimbursement request. We aren't responsible for determining the specific procedures and policies your insurance company follows, so the accuracy of this information can't be guaranteed for your individual policy. Always verify the details with your insurance company directly before submitting a claim.

Instructions for Filing a Reimbursement Claim

1. Contact your insurance company's member services department to confirm they'll accept a claim for out-of-pocket medical expenses.
2. Ask your insurance representative what information they need for the claim. Some insurers accept a generic claim form; others require a specific form of their own.
3. Complete the required form, including all the qualifying and billing information your insurance company needs to process the claim.
4. Include a copy of your invoice with the form. Your supplies will likely need to be broken out by their appropriate billing codes — for example, some insurers require a CPAP mask and its headgear to be billed as separate line items.
5. Submit your invoice and claim form the way your insurer requests, most commonly by fax or mail.
6. Wait for your reimbursement. Timing varies by company, but most insurers issue reimbursements within 30 days.

HCPCS Billing Codes for CPAP and BiPAP Supplies

These codes are used by insurance companies to process claims. Using the most accurate code for each item helps your claim get processed without unnecessary delays, and each code should correspond to an individual item listed on your invoice. Note that items like CPAP batteries, bed pillows, and certain adapters typically aren't covered, since they're commonly classified as luxury or convenience items rather than medically necessary equipment.

Physician Diagnosis Code

Some insurance companies also require a diagnosis code alongside your billing codes. The ICD-10 code for Obstructive Sleep Apnea (OSA) is G47.33.

Related Resources

For more on Medicare-specific rules, see our Medicare Notice. To understand how often insurance typically covers replacement supplies, see our Equipment Replacement Schedule. For questions about what requires a prescription, see our Prescription Policy.

Frequently Asked Questions

Does GoCPAP bill my insurance directly?

No. GoCPAP doesn't bill private insurance companies directly. You pay out of pocket at the time of purchase and can then submit a claim to your insurer for reimbursement using the process outlined above.

Can Medicare recipients submit their own reimbursement claims?

No. Medicare claims must be billed from an equipment company that holds a Medicare provider number, not submitted directly by the patient. See our Medicare Notice for more detail.

What billing code do I use for a CPAP mask cushion?

It depends on mask type: A7032 for a nasal mask cushion, A7031 for a full face mask cushion, or K0554/K0555 for hybrid mask cushions. Check the full table above for your specific item.

What diagnosis code should I include with my claim?

G47.33, the ICD-10 code for Obstructive Sleep Apnea (OSA), though your insurer may specify additional requirements.

How long does reimbursement usually take?

This varies by insurance company, but most issue reimbursements within 30 days of receiving a complete claim.

Are CPAP batteries or pillows covered by insurance?

Typically not. Items like CPAP batteries, bed pillows, and certain adapters are commonly classified as luxury or convenience items rather than medically necessary equipment, so most insurers don't reimburse for them.