Medicare Part B covers CPAP rental for 13 months, but payments stop if either rule is missed: use it at least 4 hours on 70% of nights in a 30-day stretch within the first 90 days, and attend a face-to-face clinician visit, generally during days 31–91, to document benefit.
After the $283 annual Part B deductible, Medicare pays 80% of the approved monthly rental and the beneficiary pays 20%. The patient owns the machine after 13 continuous months of covered rental. If the trial fails, Medicare stops paying for the rental and associated mask, tubing and filter supplies. The supplier can require the machine’s return because the patient does not yet own it, unless the patient pays privately or makes another arrangement. Coverage may resume after a later visit, but Medicare generally will not pay for the gap.
The machine logs use objectively, and any qualifying 30-day stretch within the first 90 days counts, so a bad first week does not automatically disqualify a patient if a qualifying stretch follows before day 90. The article recommends checking the report by week four or five and booking the reevaluation around days 60–80. A genuine trial failure generally requires a new in-person clinical evaluation explaining why therapy failed and a repeat sleep study at a facility.
