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Blue Shield Coverage Summary

If you have met your deductible for the year, most Blue Shield PPO plans provide excellent coverage for sleep apnea therapy products. These plans typically follow Medicare's guidelines for product replacement:

 

Click Here to check your Blue Shield Coverage for Sleep Apnea Products.

Product Category HCPCS Maximum Medicare Replacement Schedule
Tubing with Integrated Heating Element A4604 1 per 3 months
Combination Oral/Nasal Mask A7027 1 per 3 months
Replacement Cushion for Combination Oral/Nasal Mask A7028 1 per month
Replacement Pillows for Combination Oral/Nasal Mask A7029 1 per month
Full-Face Mask A7030 1 per 3 months
Replacement Cushion for Full-Face Mask A7031 1 per month
Replacement Cushion for Nasal Mask A7032 2 per month
Replacement Pillow for use on Nasal Mask (cannula/pillow) A7033 2 per month
Nasal Mask (mask or cannula/pillow type) A7034 1 per 3 months
Headgear A7035 1 per 6 months
Chin Strap A7036 1 per 6 months
Tubing, Standard A7037 1 per 3 months
Disposble Filter A7038 2 per month
Non Disposable Filter A7039 1 per 6 months
Oral Interface A7044 1 per 3 months
Replacement Chamber for Humidifier A7046 1 per 6 months
Bi-Level Machine without Back-Up Rate Feature E0470 1 per 5 Years
Bi-Level Machine with Back-Up Rate Feature E0471 1 per 5 Years
Humidifier, Non-Heated E0561 1 per 5 Years
Humidifier, Heated E0562 1 per 5 Years
Continuous Positive Airway Pressure ("CPAP") Machine E0601 1 per 5 Years

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