Continuous Positive Airway Pressure Device

Continuous Positive Airway Pressure Device and Bi-Level Positive Airway Pressure Device Supplies

Supplies are covered only after the ten-month rental period or following ten months after the purchase date.

• Blue Cross and Blue Shield of Alabama will not cover back up devices.
• Blue Cross and Blue Shield of Alabama will not cover replacement of a functioning device with a newer advanced model.

Click here to view the medical policy for Continuous Positive Airway Pressure Device.

CPAP compliance device/mechanism or data download for the CPAP device does not meet Blue Cross and Blue Shield of Alabama’s medical criteria for coverage.
CPAP Remote Monitoring Device does not meet Blue Cross and Blue Shield of Alabama’s medical criteria for coverage.

Bi-Level Positive Airway Pressure Spontaneous Time (Bi-PAP S/T)

Click here to view the medical policy for Bi-Level Positive Airway Pressure Spontaneous Time (Bi-PAP S/T).

Humidifier used with Positive Airway Pressure Device

Humidifiers, when medical criteria is met, will be considered for payment in addition to the Bi-PAP or CPAP machine.

Negative Pressure Ventilator, Portable or Stationary

Coverage criteria:

• Benefits provided for treatment of neuromuscular diseases; thoracic, restrictive diseases; and chronic respiratory failure consequent to chronic obstructive pulmonary disease. Includes both positive and negative pressure types.
• This is considered to be life-sustaining equipment.

Percussor, Electric or Pneumatic, Home Model

Benefits are provided for mobilizing respiratory tract secretion in patients with chronic obstructive lung disease, cystic fibrosis, chronic bronchitis, or emphysema when the patient or operator of powered percussor has received appropriate training by a physician or a therapist and there is no one competent available to administer therapy.