Medicare Coverage for CPAP Machines and Supplies
How Medicare covers sleep apnea testing, the 12-week CPAP trial and usage rule, the 13-month rental, and replacement mask and tubing supplies.
Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. Medicare Part B covers CPAP machines and related supplies as durable medical equipment, but coverage comes with specific steps: a qualifying sleep test, a trial period, and proof that you are using the device. This guide walks through those steps in plain language. It is not medical advice; your treating provider decides what therapy is right for you.
Step 1: Getting tested for sleep apnea
Medicare Part B covers Type I, II, III and IV sleep tests if you have clinical signs and symptoms of sleep apnea. A few rules apply:
- Your doctor or other health care provider must order the sleep test.
- Type I tests (attended studies) are covered only when done in a sleep lab facility. Types II, III and IV include tests that can be done at home.
- After you meet the Part B deductible, you pay 20% of the Medicare-approved amount for the test.
Medicare's detailed coverage policy for positive airway pressure devices, Local Coverage Determination L33718, also calls for an in-person clinical evaluation by your treating practitioner before the sleep test, and sets the test results needed to qualify for a device.
Step 2: The 12-week trial and the adherence requirement
If you are diagnosed with obstructive sleep apnea, Medicare may cover a 12-week trial of CPAP therapy, including the device and accessories. To keep coverage after the first three months, two things must happen:
- A follow-up visit. Under the coverage policy, your treating practitioner must re-evaluate you no sooner than day 31 and no later than day 91 after you start therapy, and document that your sleep apnea symptoms have improved.
- Objective proof that you used the device. The policy defines adherence as using CPAP at least 4 hours per night on 70% of nights during any 30 consecutive days within the first three months. Most machines record usage data, which your practitioner reviews.
If these criteria are not met, Medicare will deny continued coverage of the device and accessories. People who do not succeed in the first trial can qualify again, but the policy requires an in-person re-evaluation to find out why therapy did not work and a repeat sleep test in a facility.
If you are struggling with the mask, pressure or comfort, tell your provider and supplier early in the trial. Adjustments such as a different mask style are often possible within the covered supply rules.
Step 3: Renting the machine for 13 months
Medicare pays the supplier to rent a CPAP machine for 13 months as long as you use it continuously. After 13 months of continuous rental payments, you own the machine. During the rental period, you pay 20% of the Medicare-approved amount for the rental and for related supplies, after the Part B deductible, if your supplier accepts assignment. For 2026 the Part B deductible is $283.
While you rent, the supplier must keep the equipment in good working order. Medicare's DME coverage booklet notes that owned equipment used longer than its reasonable useful lifetime, generally 5 years, may be replaced.
Step 4: Replacement supplies
Masks, cushions, tubing and filters wear out, and Medicare covers replacements when you still meet the coverage criteria for your device. The coverage policy lists the usual maximum amounts Medicare considers reasonable. These include:
- Full face mask: 1 every 3 months; replacement full face mask cushion: 1 per month
- Nasal mask: 1 every 3 months; replacement nasal cushions: up to 2 per month
- Replacement nasal pillows (for nasal pillow masks): up to 2 per month
- Tubing (standard or heated): 1 every 3 months
- Disposable filters: up to 2 per month; non-disposable filter: 1 every 6 months
- Headgear: 1 every 6 months; chinstrap: 1 every 6 months
- Humidifier water chamber: 1 every 6 months
These are ceilings, not automatic shipments. Amounts above the usual maximum are denied as not reasonable and necessary, and you should only accept supplies you actually need and use.
Choosing a Medicare supplier for CPAP
Medicare pays only for equipment from suppliers enrolled in Medicare. When comparing suppliers, ask:
- Are you enrolled in Medicare, and do you accept assignment? A supplier that participates in Medicare must accept assignment, which limits your charge to the deductible and coinsurance.
- How do I reorder masks, cushions and filters, and how often will you contact me?
- Who helps with mask fitting and machine problems?
- Will you bill Medicare directly?
You can search for enrolled suppliers near you with Medicare's supplier directory or by calling 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048). If you have a Medicare Advantage Plan, contact the plan, because it may require specific suppliers.
Watch your statements
Review your Medicare Summary Notices for supplies you did not order or receive. Unrequested shipments billed to Medicare should be reported to 1-800-MEDICARE or the HHS Office of Inspector General hotline at 1-800-HHS-TIPS (1-800-447-8477).