Purchasing through CPAP.com is often cheaper than your copay and deductible through insurance. CPAP.com is a cash only medical distributor that does not accept insurance assignment, does not have an NPI number, and is not a participating provider with any insurance companies. A pre-populated example insurance form is available for all CPAP.com orders. To view and print the form, log into your CPAP.com account. The pre-populated form may be used to seek reimbursement from your insurance company. CPAP.com is out of network for private insurance companies. Check with your private insurer to see if they will reimburse your purchase. Medicare, Medicaid and other government run healthcare programs will not reimburse CPAP.com purchases.
- Will my insurance company reimburse my online cash purchase?
Reimbursement is an agreement between you and your insurance company. If you are planning on seeking reimbursement, be sure to check with your insurance company first! CPAP.com is out of network for all insurance plans. In most cases private insurance will consider reimbursing.
CPAP.com is a cash based, high volume, direct to patient business model. We avoid dealing directly with insurance companies and pass the resulting savings onto our customers.
However, we do provide our customers with an insurance compliant, itemized invoice that contains applicable insurance billing code(s) for each item purchased.
Additionally, CPAPtalk.com is a good resource for those with questions about reimbursement as many CPAPtalk.com users regularly purchase from CPAP.com and obtain reimbursement from their private insurance companies.
- Do you accept private insurance?
- No, our website is a self pay website that does not deal directly with insurance companies. We do provide insurance compliant invoices that allow you to seek reimbursement from your insurance company. Check with your insurance carrier regarding their policy for reimbursement for out of network providers.
- Do you accept Medicare?
- No, CPAP.com does not accept Medicare assignment and has no relationship with them.
- Do you accept Medicaid?
- No, CPAP.com does not accept Medicaid and has no relationship with them.
- What Determines the Date of Service on the Insurance Claim Form?
The Date of Service is the date the package ships from our warehouse to you. The Date of Service is referenced on CPAP.com invoices as the Date Shipped.
CPAP.com ships Monday - Friday except during holidays and weather related events.
As an example, if an order is placed on Saturday, March 31st and the parcel ships out on Monday, April 2 the invoice will reflect April 2 as the Date of Service on the claim form and invoice.
As another example, if an order is placed Thursday, September 18th and the parcel ships out on Friday, September 19th then the invoice will reflect September 19th as Date of Service on the claim form and invoice in the Date Shipped field. The Date Placed field on the order will be September 18th but this date will not be used by insurance companies. Here is a picture of this example invoice:
The Date of Service / Date Shipped cannot be changed.
- What is the Tax ID for CPAP.com?
- If you are self filing an insurance claim enter the company name as "US Expediters, Inc." which is our parent company. Use the Tax ID of "760521364".
- Does CPAP.com have an NPI number?
- No, CPAP.com does not have an NPI (National Provider Identifier) because we are a self-pay, cash business and do not submit claims to any insurance companies.
- What is the HSA MCC Code for CPAP.com?
- CPAP.com's MCC code for HSA purchases is 5047: Medical, Dental Ophthalmic, Hospital Equipment and Supplies.
- What Place of Service code is used for a CPAP.com purchase?
- If product is shipped out to you from CPAP.com, the Place of Service code used is "99". If you come to the CPAP.com office to pick up an order, use code "17" to indicate the Place of Service.
- What is the diagnosis code?
The diagnosis code for Obstructive Sleep Apnea (OSA) is g47.33.
The diagnosis code for Hypersomnia with sleep apnea, unspecified is 780.53.
The diagnosis code for Other unspecified sleep apnea is 780.57.
- My insurance company is asking for CPT codes, what are they?
Every medical product or service has a CPT (Current Procedural Terminology) code assigned to it. Government healthcare providers use HCPCS (Healthcare Common Procedure Coding System) which are generally the same as the CPT codes. Frequently the CPT or HCPCS code are referred to a "billing codes".
All insurance information should be verified with your insurance company.
CPAP.com provides the CPT codes for every product sold in two ways.
- Order Receipt: Each line item on the receipt or invoice notes the Billing Code.
- Pre-populated Insurance Form: Available through your CPAP.com account for each order placed.
- What are the CPAP, BiPAP, Sleep Apnea, and Oxygen related HCPCS, CPT or billing codes?
- A7034 is Nasal Mask
- A7034 is Nasal Pillow Mask
- A7030 is Full Face Mask
- A7027 is Hybrid Mask
- A7044 is Oral Interface Mask (Oracle)
- A7035 is Headgear for Mask - Any Style
- A7036 is Chinstrap - Any Style
- A7032 is Replacement Nasal Mask Cushion
- A7033 is Replacement Nasal pillows
- A7031 is Replacement Full Face Mask Cushion
- A7028 is Replacement Hybrid Mask Cushion
- A7029 is Replacement Hybrid Mask Nasal Pillow
- A7046 is Replacement Humidifier Chamber
- A7037 is Tubing / Hose - Long & Short Tubes
- A4604 is Heated Tubing
- A7038 is Disposable Filter (White / Paper)
- A7039 is Washable Filter (Gross Particle / Foam/ Black)
- E0601 NU is CPAP Purchase
- E0601 NU is APAP Purchase
- E0470 NU is BiPAP Purchase
- E0470 NU is BiPAP Auto Purchase
- E0471 NU is BiPAP ST Purchase
- E0471 NU is BiPAP Auto SV Purchase
- E0562 NU is Heated CPAP Humidifier
- E0561 NU is Passover or Cool CPAP Humidifier
- E0601 RR is CPAP Rental
- E0601 NU is APAP Rental
- E0470 RR is BiPAP Rental
- E0470 RR is BiPAP Auto Rental
- E0471 RR is BiPAP ST Rental
- E0471 RR is BiPAP Auto SV Rental
- E1356 is Oxygen Concentrator Battery
- E1357 is Oxygen Concentrator Battery Charger
- E1358 is Oxygen Concentrator DC Cable
- E1390 is Portable Oxygen Concentrator
E1399 is Miscellaneous and is used for other CPAP and Oxygen items.
- How Can I Get a CPAP Machine without Insurance?
CPAP machines, masks, supplies, and accessories can all be purchased without using insurance. The only thing required to purchase CPAP machines and masks is a valid prescription from a doctor.
Some CPAP suppliers, (like CPAP.com), specialize in selling CPAP equipment to individuals outside of using insurance, and in many cases offer customers who choose to shop this way a substantial cost savings. Because CPAP.com doesn't bill insurance directly, it's a lot less expensive than going the traditional insurance route, and the savings are passed on to the customer.
CPAP.com also makes it possible for individuals to file a claim for CPAP equipment purchased from CPAP.com by using our handy Self-Filing Insurance Tool. With this tool, customers can access the correct forms to use when filing a claim. CPAP.com is considered an out-of-network DME by most insurance companies, and it's important to verify with the specific provider before purchasing, as it's no guarantee of reimbursement by using the Self-Filing Insurance Tool.
CPAP Users Say
CPAPtalk.com CPAP User Discussions
Did You Know?, Insurance
- Auto adjusting CPAPs adjust to your breathing on a breath-by-breath basis.
- CPAP.com does repairs on machines purchased from us! And loaner equipment is available in the interim for a fee.
- Humidifier chambers should be replaced every six months.
- While reusable filters can be rinsed out, they still need to be replaced as they wear out, about every six months.
CPAPtalk.com Wiki Articles
- Working with Physicians, Insurance and DMEs
- Working with the VA
- Diagnosing Sleep Apnea without Insurance
- Suggested Specific CPAP Equipment Rx/Scripts