Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea (OSA)
After reconsideration, coverage for CPAP therapy for OSA is expanded to include a positive diagnosis of OSA made using a home sleep test under specified criteria. This revision is a national coverage determination (NCD). NCDs are binding on all carriers, fiscal intermediaries, quality improvement organizations, qualified independent contractors, the Medicare appeals council, and administrative law judges (ALJs) (see 42 CFR section 405.1060(a)(4) (2005)). An NCD that expands coverage is also binding on a Medicare advantage organization. In addition, an ALJ may not review an NCD. (See section 1869(f)(1)(A)(i) of the Social Security Act.)
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 15, 2008
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