Medicare Coverage Issues Manual
Section 60-17, Continuous Positive Airway Pressure (CPAP), is revised to expand Medicare coverage for CPAP in the use of obstructive sleep apnea (OSA). Medicare contractors must develop a method for monitoring compliance for CPAP devices. This revision to the Coverage Issues Manual is a national coverage decision (NCD). NCDs are binding on all Medicare carriers, intermediaries, peer review organizations, Health Maintenance Organizations, Competitive Medical Plans, and Health Care Prepayment Plans. Under 42 CFR 422.256 (b), an NCD that expands coverage is also binding on Medicare +Choice Organization. In addition, an administrative law judge may not review an NCD. (See §1869 (f)(1)(A)(I) of the Social Security Act
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: December 26, 2001
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