Insurance, Medicare and cost
Medicare CPAP Coverage Rules Explained (2026)
Medicare Part B covers a CPAP for adults diagnosed with obstructive sleep apnea who meet sleep test criteria, starting with a 12 week trial. If you use it enough and your clinician documents benefit, Medicare keeps paying rental for 13 continuous months, after which you own the machine; you generally pay 20% of the approved amount after the Part B deductible.
Who qualifies
Under the CMS coverage policy for PAP devices (LCD L33718, in the revision effective January 1, 2024 as checked in October 2026), you need an in-person or telehealth clinical evaluation before your sleep test, then a sleep test showing an AHI or RDI of 15 or more events per hour (with at least 30 events), or 5 to 14 events per hour (with at least 10 events) plus documented symptoms or conditions.
Qualifying symptoms are excessive daytime sleepiness, impaired cognition, mood disorders or insomnia; qualifying conditions are hypertension, ischemic heart disease or a history of stroke. Both in-lab and home sleep tests are accepted.
The 12 week trial
Medicare.gov describes the first stage as a 12 week trial of CPAP therapy, including devices and accessories. During this time your supplier gives you instructions and your machine records your usage.
To continue past the trial, you must meet the adherence rule (4 hours or more per night on 70% of nights in a consecutive 30 day period within the first 3 months) and have a follow-up visit between day 31 and day 91 where your clinician documents that your symptoms improved. See our dedicated compliance guide for details.
Rent to own over 13 months
Medicare pays for CPAP as a capped rental. According to Medicare.gov, Medicare covers rental for 13 months if you use the machine without interruption, and after 13 continuous months of rental payments you own it.
Your share is generally 20% of the Medicare approved amount after you meet the Part B deductible, if your supplier accepts assignment. Medicare Advantage plans cover CPAP too, but their costs, networks and prior authorization rules vary.
Supplies and replacements
Masks, cushions, tubing, filters and water chambers are covered on a replacement schedule with usual maximum quantities (for example 1 full face mask every 3 months, 2 nasal cushions per month, 2 disposable filters per month). See our supply replacement schedule guide for the full table.
Suppliers must contact you no sooner than 30 days before your current supply runs out and get your affirmative answer before shipping. Auto shipping is not allowed under the policy.
If you had CPAP before Medicare
If you got your machine through private insurance before joining Medicare, Medicare can still pay for rental, a replacement machine or supplies if you have documentation of a qualifying sleep test from before enrollment and an in-person evaluation after enrollment confirming you have sleep apnea and still use the device.
You do not need to repeat the 90 day adherence trial in that situation, according to the LCD.
Frequently asked questions
Does Medicare pay for a CPAP machine?
Yes, Part B covers CPAP for adults with obstructive sleep apnea who meet the sleep test criteria. It starts with a 12 week trial and continues if you meet the usage and follow-up requirements.
How much does a CPAP cost with Medicare?
You generally pay 20% of the Medicare approved amount for the rental and supplies after your Part B deductible, if the supplier accepts assignment. Medigap or Medicare Advantage can change that amount.
Do I own my CPAP after Medicare pays for it?
Yes. After 13 continuous months of rental payments, you own the machine, according to Medicare.gov.
Will Medicare take my CPAP back if I do not use it?
If you do not meet the adherence and follow-up rules in the first 3 months, Medicare stops covering it and the supplier usually picks up the rental. You can requalify later with a new evaluation and an in-lab sleep test.
Does Medicare cover BiPAP?
For obstructive sleep apnea, Medicare covers a bilevel device without backup rate (E0470) only if you meet the CPAP criteria and CPAP was tried and proven ineffective.
Sources
Last reviewed October 11, 2026. How we research · Report an error