Under TRICARE’s Durable Medical Equipment (DME) benefit, beneficiaries who have been diagnosed with obstructive sleep apnea syndrome or respiratory insufficiency, may be eligible to receive a Continuous Positive Airway Pressure (CPAP) machine. Prior authorization is required for this limited benefit.
TRICARE may also cover a portable CPAP machine for Active Duty Service Members (ADSM) with a referral that states the beneficiary:
Please provide a description and bill under Healthcare Common Procedure Coding System (HCPCS) code E1399.
See additional information about TRICARE CPAP machine benefit, conditions and exclusions