A CPAP machine does not stay in one payment lane. It may begin as rented equipment, become the patient’s property, and continue generating separate claims for masks, tubing, filters, and other supplies. If you do not track those lanes separately, you can end up arguing about a repair without knowing who owns the machine or approving supplies without knowing what Medicare was billed.

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Start with one question for the supplier: Is this machine still rented, or does the patient own it? Do not accept “Medicare covers it” as the answer. Ask for the rental start, the number of rental payments Medicare has made, the machine’s serial number, and the date the supplier expects ownership to transfer.

This guide addresses payment and paperwork. Questions about whether the machine is helping, whether settings should change, or whether use should continue belong with the treating clinician.

Who pays

Under Original Medicare, Part B may cover a prescribed CPAP machine and related supplies for use in the home when Medicare’s coverage requirements are met. Medicare describes the machine as a rental and says ownership passes to the beneficiary after Medicare makes 13 continuous rental payments, provided the machine is being used continuously. The Part B deductible and coinsurance rules apply. The amount you owe depends on the Medicare-approved amount, assignment, and any secondary coverage. Ask Medicare or the insurer for the actual amount rather than relying on a supplier estimate. Source: Medicare, Continuous Positive Airway Pressure therapy.

If the patient has Medicare Advantage, stop using the Original Medicare payment path as your operating assumption. Call the plan and ask whether the supplier is in network, whether authorization is required, whether the machine remains rented, and where repairs and replacement supplies must come from. Record the representative’s name, the call reference number, and the exact equipment and supply categories discussed.

With Original Medicare, ask whether the supplier is enrolled in Medicare and accepts assignment for every remaining rental month. A participating supplier must accept assignment. A nonparticipating supplier may decide whether to accept it. Medicare specifically tells beneficiaries renting equipment to confirm assignment for all rental months. Source: Medicare, Durable medical equipment coverage.

Keep the machine and its supplies in separate columns. The machine may be a rental while masks, tubing, filters, cushions, or other accessories are billed as purchased supplies. A paid machine rental claim does not prove that every supply shipment is covered. Ask the supplier for the billing code, quantity, service date, and expected patient responsibility for each item before approving it.

The papers

Build a CPAP ownership sheet at the front of the file. Put these fields on it:

Patient name and Medicare number; Original Medicare or plan name; supplier’s legal name and billing telephone number; machine make, model, and serial number; delivery date; rental start; rental months already paid; expected ownership month; assignment status; warranty contact; treating practitioner; and the next supply order that is actually needed.

Behind that sheet, keep five records:

The order. CMS calls the basic prescription a Standard Written Order. Its required elements include the beneficiary’s name or Medicare number, the order date, a description of the item, the treating practitioner’s name or National Provider Identifier, and the practitioner’s signature. Supplies billed separately should be identified separately. Source: CMS, DMEPOS General Documentation Requirements.

The delivery record. Match the model and serial number on the machine to the delivery ticket. Note every accessory delivered. Do not sign a blank ticket or a ticket listing items that are missing. CMS requires suppliers to maintain proof of delivery for billed equipment and supplies. Your copy gives you something concrete to compare with later claims.

The rental claims. Save each Durable Medical Equipment Medicare Summary Notice, or the equivalent plan explanation of benefits. The Medicare notice is not a bill. It shows what the supplier billed, Medicare’s decision, the approved amount, what Medicare paid, and the maximum amount you may owe. Compare its service date and equipment description with the supplier invoice. Source: Medicare, Medicare Summary Notice.

The supply log. For every shipment, write down what was requested, who requested it, what arrived, and what was billed. Do not treat the supplier’s suggested shipment cycle as proof of coverage or need. Ask which items are being replaced, why the supplier believes they are eligible, and whether a current order or clinical record is missing.

The service record. Log the first sign of trouble, the error message, whom you called, the ticket number, and the promised response. Keep photographs of damage and copies of shipping labels if the machine leaves the house. Do not record passwords or portal credentials in a file other people can see.

The ownership handoff

During the rental, the supplier must maintain and repair the equipment and keep it in working order. Medicare tells beneficiaries to call Medicare if a rental supplier will not respond to requests for service, repair, or replacement. Source: Medicare, Medicare Coverage of Durable Medical Equipment and Other Devices.

Ownership changes the job. Once the patient owns the machine, the supplier that furnished it is not automatically required to repair it. That is why you need the ownership date, serial number, warranty, and a repair contact before the final rental claim disappears from view.

Call the supplier before the expected handoff and ask:

“After the final rental payment, who takes repair calls?”

“Which repairs are covered by the warranty?”

“Will you submit covered repair claims to Medicare after ownership?”

“If you will not service an owned machine, which Medicare-enrolled repair supplier should receive the record?”

“Can you give me the model, serial number, warranty terms, and ownership status in writing?”

Do not assume that buying supplies from a company makes that company responsible for repairing the machine. Confirm the repair role separately. Medicare’s supplier directory can identify enrolled equipment suppliers, but call before moving the machine. Ask whether the location services that exact type of patient-owned equipment and whether it will bill Medicare.

Keep refills attached to the record

Ownership does not end the need for documentation. CMS tells its contractors to look for continued medical necessity and the necessity of refill accessories when reviewing claims for supplies used with a beneficiary-owned CPAP machine. The supplier may need information from the treating practitioner. Source: CMS, Medicare Program Integrity Manual, Chapter 5.

When a refill stalls, ask the supplier to name the missing document. Is it the Standard Written Order, a description of the supply, proof of continued need, a plan authorization, or something else? Then send that exact request to the treating practitioner’s office. Do not ask the office to “fix Medicare” without identifying the document.

When a supplier calls about automatic supplies, slow the transaction down. Ask for the item names, quantities, billing codes, expected ship date, and expected patient responsibility. Confirm what is worn out or exhausted. Keep the answer with the shipment record. The safe signature is the one attached to an accurate itemized record, not a general consent to whatever the supplier chooses to send.

When a claim or repair goes wrong

First identify the failure lane. A supplier invoice problem goes to supplier billing. A denied Original Medicare claim starts with the Medicare Summary Notice. A Medicare Advantage denial starts with the plan’s written denial and appeal instructions. A missing or inadequate clinical record goes to the treating practitioner. A machine setting, symptom, or treatment question goes to the clinician, not the billing desk.

For an Original Medicare denial, compare the denial code with the order, delivery record, and supply log. Ask the supplier whether it submitted the correct item, quantity, and documentation. If information was missing or entered incorrectly, ask whether the claim can be corrected. If you disagree with Medicare’s decision, the first appeal is a redetermination. Medicare identifies Form CMS-20027, Redetermination Request, for that step. Follow the deadline and mailing instructions printed on the notice rather than copying an address from an old form.

If the patient wants another person to handle the appeal, Medicare identifies Form CMS-1696, Appointment of Representative. Do not sign for the patient unless you already have authority that applies to the action. Questions about powers of attorney, capacity, contracts, or who may legally sign stop here and go to a Missouri lawyer.

Free help

For an Original Medicare equipment or claim question, call 1-800-MEDICARE. Have the Medicare Summary Notice, supplier name, service date, billing code, and machine serial number in front of you. Ask whether the claim is rental, purchase, supply, or repair, and ask what the record shows about payment. Send every rate question to Medicare, the plan, or the supplier because the answer depends on the claim and coverage in front of you.

Missouri SHIP provides free, unbiased Medicare counseling at 1-800-390-3330. A counselor can help you read notices, organize bills, and understand Medicare or plan claim routes. For additional local contacts, use Local Help With Paying for Care.

Use the public-source register on the Sources page to locate the Medicare and CMS materials named in this guide. Bring the ownership sheet, order, delivery ticket, latest claim notice, supplier invoice, and call log to any help session. Those six records let the next person see the machine, the payer, and the unresolved task without rebuilding the story from memory.

The CPAP Rental Is Running. Track Ownership, Supplies, and Repairs Before the Machine Stops