CPAP & BiPAP HCPCS Codes and Medicare Coverage
Positive airway pressure devices for obstructive sleep apnea are a capped rental. Masks, tubing and filters are replaced on a fixed schedule. This category spans 21 active HCPCS codes, 21 of them with a 2026 Medicare DMEPOS fee. Coverage is set by LCD L33718 (Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea).
Equipment in this category
Medicare coverage policy
- L33718: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- A52467: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - Policy Article
All cpap and sleep apnea devices codes
| Code | Description | Medicare coverage | DMEPOS fee (state range) | Medicare services |
|---|---|---|---|---|
| E0601 | Continuous positive airway pressure (CPAP) device | Special coverage instructions apply | $50.04–$100.22 (RR) | 4,211,936 (2024) |
| E0470 | Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | Special coverage instructions apply | $129.84–$237.27 (RR) | 540,678 (2024) |
| E0471 | Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) | Special coverage instructions apply | $324.35–$642.07 (RR) | 188,380 (2024) |
| E0561 | Humidifier, non-heated, used with positive airway pressure device | Carrier judgment | $84.58–$128.48 (NU) | 69 (2024) |
| E0562 | Humidifier, heated, used with positive airway pressure device | Carrier judgment | $168.20–$316.53 (NU) | 1,370,309 (2024) |
| A7027 | Combination oral/nasal mask, used with continuous positive airway pressure device, each | Carrier judgment | $142.24–$218.86 (NU) | 398 (2024) |
| A7028 | Oral cushion for combination oral/nasal mask, replacement only, each | Carrier judgment | $40.30–$66.05 (NU) | 431 (2024) |
| A7029 | Nasal pillows for combination oral/nasal mask, replacement only, pair | Carrier judgment | $18.73–$27.93 (NU) | 568 (2024) |
| A7030 | Full face mask used with positive airway pressure device, each | Carrier judgment | $109.52–$200.55 (NU) | 2,020,250 (2024) |
| A7031 | Face mask interface, replacement for full face mask, each | Carrier judgment | $41.70–$74.80 (NU) | 5,234,511 (2024) |
| A7032 | Cushion for use on nasal mask interface, replacement only, each | Carrier judgment | $23.09–$42.96 (NU) | 7,519,268 (2024) |
| A7033 | Pillow for use on nasal cannula type interface, replacement only, pair | Carrier judgment | $19.26–$31.66 (NU) | 5,252,856 (2024) |
| A7034 | Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap | Carrier judgment | $67.86–$125.21 (NU) | 2,475,817 (2024) |
| A7035 | Headgear used with positive airway pressure device | Carrier judgment | $22.56–$38.30 (NU) | 2,634,136 (2024) |
| A7036 | Chinstrap used with positive airway pressure device | Carrier judgment | $12.95–$18.48 (NU) | 239,336 (2024) |
| A7037 | Tubing used with positive airway pressure device | Carrier judgment | $14.19–$36.48 (NU) | 1,268,722 (2024) |
| A7038 | Filter, disposable, used with positive airway pressure device | Carrier judgment | $2.55–$5.23 (NU) | 23,201,087 (2024) |
| A7039 | Filter, non disposable, used with positive airway pressure device | Carrier judgment | $7.39–$13.60 (NU) | 512,044 (2024) |
| A7044 | Oral interface used with positive airway pressure device, each | Carrier judgment | $98.74–$146.47 (NU) | 187 (2024) |
| A7046 | Water chamber for humidifier, used with positive airway pressure device, replacement, each | Special coverage instructions apply | $15.83–$23.57 (NU) | 1,797,000 (2024) |
| A4604 | Tubing with integrated heating element for use with positive airway pressure device | Carrier judgment | $49.31–$76.79 (NU) | 3,056,009 (2024) |
Frequently asked questions
Which HCPCS codes are used for cpap and sleep apnea devices?
A7038 (Pos airway pressure filter); A7032 (Replacement nasal cushion); A7033 (Replacement nasal pillows); A7031 (Replacement facemask interfa); E0601 (Cont airway pressure device).
Which Medicare policy covers cpap and sleep apnea devices?
L33718: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea; A52467: Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea - Policy Article.
Which cpap and sleep apnea devices codes does Medicare pay for most often?
A7038: 23,201,087 services in 2024; A7032: 7,519,268 services in 2024; A7033: 5,252,856 services in 2024; A7031: 5,234,511 services in 2024; E0601: 4,211,936 services in 2024.
Next steps
- Run a reimbursement report for a device billed under A7038
- Watch A7038 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for A7038
Sources: CMS HCPCS Level II; CMS DMEPOS fee schedule 2026; CMS Medicare Coverage Database. Not billing or legal advice.