Find Senior Care (City or Zip)
Join Now Log In
O
olyrover Asked March 2016

Does Medicare require a new sleep study to replace an old CPAP machine?

I've been using the same cpap for 10 years. lately I wake up gasping for air until I get the mask off. some say i need a new sleep study before medicare will approve it, others say it is not required. //

olyrover Mar 2016
thanks for the answer and you're probably right, but i have found statements from reliable sources that state, according to medicare guidelines, the sleep study is not required for replacing a cpap over 5 years old.

GardenArtist Mar 2016
Oly, rely on what your pulmonary physician advises. His/her staff are the ones who deal with Medicare and know what the requirements are.

Medicare's payment of DME supplies has changed drastically since Medicare mandated competitive bidding for DME equipment. I've been told by our former oxygen equipment supplier that many companies, especially small ones, have gone out of business.

Payment by Medicare has been refined and keyed to overnight tests, specific oxygen saturation rates, and is very, very specific. It was much harder to get oxygen this time than when we had it some years ago.

If you haven't had a sleep test in 10 years, and if you're gasping for air while wearing it, to me that's a good indication that a test is necessary one way or the other.

I don't know what the life of a CPAP is, but yours might be nearing the end of its usefulness.

Call your pulmonary doctor, ask him/her to have the staff arrange for a sleep study if that's what they're telling you is necessary.

ADVERTISEMENT


olyrover Mar 2016
as i said, some say, including my doctor, that i need the new study, but i'm sure i saw it on a medicare website that said it was no longer needed if i had already had the sleep studies in order to obtain my original cpap.

BarbBrooklyn Mar 2016
Why don't you call your doctor?

ADVERTISEMENT

Ask a Question

Subscribe to
Our Newsletter