At CPAP EquipSource, we are a private-pay CPAP and medical equipment retailer. We do not bill Medicare, Medicaid, or commercial health insurance directly.
However, if your health insurance plan provides an out-of-network benefit for CPAP equipment or supplies, you may be able to submit your purchase to your insurance company for possible reimbursement.
When you purchase qualifying CPAP equipment or supplies from us, we can provide you with an itemized receipt and applicable HCPCS billing codes to help you complete your insurance claim.
Please note: Providing a receipt or billing code does not guarantee that your insurance company will reimburse you. Coverage, deductibles, coinsurance, out-of-network benefits, and claim requirements are determined by your individual insurance plan.
Before purchasing, we recommend contacting your insurance company and asking whether your plan provides out-of-network coverage for durable medical equipment (DME), CPAP equipment, or CPAP supplies.
The phone number for your insurance company's member services department is usually located on the back of your insurance card.
Ask your insurance company:
Do I have out-of-network DME benefits?
Are CPAP machines and supplies covered under my plan?
Is a prescription required?
Do I need prior authorization?
Do I need a specific diagnosis code?
What out-of-network claim form should I use?
Where should I submit my claim?
What documentation is required?
What portion of my purchase may be eligible for reimbursement?
Insurance policies vary, so we recommend confirming these requirements before placing your order.
CPAP EquipSource operates as a private-pay retailer. You pay CPAP EquipSource directly for your equipment or supplies.
After your purchase, we can provide an itemized invoice/receipt showing the products purchased, quantities, charges, and applicable billing information.
Your invoice may include the applicable HCPCS code (s) associated with the equipment or supplies purchased.
If your insurance company requires an out-of-network claim form, obtain the appropriate form directly from your insurance company.
Many insurance companies allow members to download claim forms through their member website or mobile app.
You can also contact the member services number on the back of your insurance card and request the appropriate out-of-network DME claim form.
Do not assume that the same form or procedure applies to every insurance company. Requirements can vary by plan.
Your insurance company's claim form will typically request information such as:
Your name and address
Date of birth
Member ID
Group number, if applicable
Insurance company information
Date of purchase or date of service
Description of the equipment or supplies
Quantity purchased
Amount paid
Provider or supplier information
HCPCS code(s)
Diagnosis information, if required
Use the information provided on your CPAP EquipSource invoice when completing the claim.
If your insurance company requires information that is not shown on your receipt, contact your insurance provider for instructions before submitting the claim.
HCPCS codes are standardized billing codes used to identify medical equipment and supplies.
Some commonly used codes associated with PAP equipment include:
| HCPCS Code | General Description |
|---|---|
| E0601 | CPAP/APAP device |
| E0470 | Bi-level respiratory assist device without backup rate |
| E0471 | Bi-level respiratory assist device with backup rate |
| E0561 | Non-heated humidifier for PAP |
| E0562 | Heated humidifier for PAP |
| A7030 | Full-face CPAP mask |
| A7031 | Replacement full-face mask interface |
| A7032 | Replacement nasal mask cushion |
| A7033 | Replacement nasal pillows |
| A7034 | Nasal mask/interface |
| A7035 | PAP headgear |
| A7036 | PAP chinstrap |
| A7037 | PAP tubing |
| A7038 | Disposable PAP filter |
| A7039 | Non-disposable/reusable PAP filter |
| A7046 | PAP humidifier water chamber |
| A4604 | Heated PAP tubing |
These are examples of commonly used PAP-related HCPCS codes. CMS maintains and updates the HCPCS code system, and individual insurance plans may have their own claim requirements.
For Medicare-related PAP coverage, CMS identifies the applicable HCPCS codes and coverage requirements through its Medicare coverage policies.
Always verify the applicable code and claim requirements with your insurance company before submitting a claim.
Once your claim form is completed, review it carefully to make sure the information is accurate.
Include the documentation requested by your insurance company. This may include:
Completed claim form
CPAP EquipSource itemized invoice or receipt
Prescription or physician documentation, if required
Any other supporting documentation requested by your plan
Submit the claim using the method specified by your insurance company.
Depending on your insurance plan, claims may be submitted by:
Online member portal
Insurance company mobile app
Fax, if permitted
Your insurance company will review the claim according to the terms of your individual insurance plan.
Possible outcomes may include:
Full or partial reimbursement
Application toward your deductible
Application toward your out-of-network maximum
Denial because the item is not covered
Denial because you have no out-of-network benefits
Request for additional documentation
CPAP EquipSource cannot guarantee reimbursement or determine how your insurance company will process your claim.
For questions about coverage or reimbursement, contact your insurance company's member services department.
Although we do not submit insurance claims on behalf of our customers, we understand that insurance paperwork can sometimes be confusing.
That's why we provide customers with clear, itemized documentation for their purchase, including applicable billing information when available.
Our goal is to make it as straightforward as possible for you to submit your own out-of-network claim.
If you need help understanding the information shown on your CPAP EquipSource invoice, contact us and we'll be happy to help explain the information we provide.
For questions about whether your insurance plan will pay for your purchase, please contact your insurance company directly.
CPAP EquipSource is a private-pay retailer and does not submit or process insurance claims on behalf of customers.
Providing an invoice, receipt, or HCPCS code does not mean that an item is covered by your insurance plan and does not guarantee reimbursement.
Insurance coverage varies by plan. Customers are responsible for confirming eligibility, coverage, deductibles, out-of-network benefits, documentation requirements, and reimbursement policies directly with their insurance provider.
Please contact your insurance company before making a purchase if insurance reimbursement is an important consideration.
