Hi everyone,
I am doing a study for one of my college classes about government spending, and because my parents have sleep apnea, I am investigating Medicare funding for CPAP and sleep apnea. Does anyone know where I can find a history of Medicare spending on CPAP reimbursement or statistics on how much the industry has grown over the past 10-20 years. Any information is helpful, and thanks a lot.
Government Spending on CPAP
Re: Government Spending on CPAP
Not overall what you want, but individualized and w/lowering reimbursements each year.
2006
SLEEP STUDIES: One night of sleep evaluation and one night of CPAP titration
Billed: $3,300.00 - Allowed: $1,700.54 - Medicare paid: $1,360.44 - Patient copy: $340.10
95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep: $1650.00 - $680.22 95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep: $1650.00 - $680.22
CPAP 13 Months Capped Rental
Billed: $135.00 - Allowed: $99.95 - Medicare paid: $79.96 - Patient copay: $19.99
ACCESORIES:
Billed: $548.00 - Allowed: $499.63 - Medicare paid: $399.70 - Patient copay: $99.93
a7037 - tubing used with positive airway pressure device - $48.00 - $32.82
a7034 - nasal interface (mask or cannula type) used with positive airway pressure device - $130.00 - $94.11
a7035 - headgear used with positive airway pressure device - $45.00 - $31.80
e0562 - humidifier, heated, used with positive airway pressure device - $325.00 - $240.97
2008
SLEEP STUDIES: One night of sleep evaluation and one night of BI-LEVEL titration
Billed: $1,850.00 - Allowed: $765.04 - Medicare paid: 612.03
95810 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep
Billed: $2,000.00 - Allowed: $840.12 - Medicare paid: $672.10
95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep
BI-LEVEL 13 Months Capped Rental
Billed: $239.92 - Allowed: $218.11 - Medicare paid: $174.49 - Patient copay: $43.62
ACCESSORIES
Mask
Billed: $199.40 - Allowed: $157.39 - Medicare paid: $125.91 - Patient copay: $31.48
2006
SLEEP STUDIES: One night of sleep evaluation and one night of CPAP titration
Billed: $3,300.00 - Allowed: $1,700.54 - Medicare paid: $1,360.44 - Patient copy: $340.10
95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep: $1650.00 - $680.22 95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep: $1650.00 - $680.22
CPAP 13 Months Capped Rental
Billed: $135.00 - Allowed: $99.95 - Medicare paid: $79.96 - Patient copay: $19.99
ACCESORIES:
Billed: $548.00 - Allowed: $499.63 - Medicare paid: $399.70 - Patient copay: $99.93
a7037 - tubing used with positive airway pressure device - $48.00 - $32.82
a7034 - nasal interface (mask or cannula type) used with positive airway pressure device - $130.00 - $94.11
a7035 - headgear used with positive airway pressure device - $45.00 - $31.80
e0562 - humidifier, heated, used with positive airway pressure device - $325.00 - $240.97
2008
SLEEP STUDIES: One night of sleep evaluation and one night of BI-LEVEL titration
Billed: $1,850.00 - Allowed: $765.04 - Medicare paid: 612.03
95810 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep
Billed: $2,000.00 - Allowed: $840.12 - Medicare paid: $672.10
95811 - Polysomnography; Sleep Staging With 4 Or More Additional Parameters Of Sleep
BI-LEVEL 13 Months Capped Rental
Billed: $239.92 - Allowed: $218.11 - Medicare paid: $174.49 - Patient copay: $43.62
ACCESSORIES
Mask
Billed: $199.40 - Allowed: $157.39 - Medicare paid: $125.91 - Patient copay: $31.48
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| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
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