‘CPAP Mask of Choice' Is Now OK for Medicare Beneficiaries

Published in Member Communities on August 06, 2024

Featured in Sleep Review Magazine, Ronda Buhrmester, Senior Director of Payer Relations of VGM & Associates, shares her insight on recently established guidelines for completing a CPAP mask standard written order. 

The DME-MACs have issued new guidelines allowing generic descriptions for CPAP masks in standard written orders, promoting patient adherence and reducing delays in therapy. 

Durable medical equipment (DME) suppliers and CPAP mask manufacturers support the change as it provides flexibility and speeds up and simplifies the process of finding the right mask for patients and eliminates the need for new orders with each mask switch. Ronda Buhrmester says, “It’s been huge for our industry.” 

The new guidelines allow patients to switch masks more easily without needing a new prescription, enhancing comfort and compliance with CPAP therapy. Buhrmester adds, "We can just work with the patient to determine what’s best for them to get them compliant." 

Emphasizing that a one-night sleep lab experience is not the best way to determine a patient’s CPAP mask choice, she adds that the home environment and daily use can change how the mask fits and works. While sleep centers are experts in diagnosing and setting CPAP pressure, they might not necessarily have that same expertise when it comes to mask selection. DMEs have trained staff who understand patient needs and compliance. If DMEs aren’t providing appropriate masks, patients should switch suppliers. Most suppliers do good business, and there are alternatives available. 

To read the full article, click here. 

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1. billing & reimbursement
2. cpap
3. reimbursement
4. vgm
5. vgm government