CPAP Qualifications Guide: What You Need (and Why It Matters)

Getting a CPAP should feel straightforward—not stressful. If you’re starting CPAP therapy for the first time or replacing an older machine, this guide breaks down exactly what documentation is typically required so we can get you set up faster.

Quick Checklist (Most Common Requirements)
To qualify for CPAP through insurance, you’ll usually need:

• In-person doctor visit documentation
• A qualifying sleep study
• A complete CPAP order (with settings)
• Patient demographics + insurance info

Starting CPAP Therapy (New CPAP Setup)

If you’re new to CPAP, here’s what you’ll need:

1) In-Person Doctor Visit Documentation

Your physician must document symptoms of sleep apnea and the need for a sleep study.

2) A Qualifying Sleep Study

Your sleep study must show:

• AHI/REI greater than 5
• Interpreted, signed, and dated by an AASM Board Certified Sleep Medicine Physician

3) A Complete CPAP Order (With Settings)

Your CPAP order must include:

• Therapy settings
• Humidifier and supplies
• Signed and dated by the ordering physician

4) Patient Demographics + Insurance Information

We’ll need your basic patient info and insurance details to verify coverage.

Replacing a CPAP Machine (Replacement Order)

If you’ve had CPAP therapy before and need a replacement, you’ll typically need:

1) In-Person Doctor Visit Showing Continued Need

Your physician must document:

• Continued need for CPAP
• That you’re using it and benefiting from therapy

2) A Complete CPAP Order (With Settings)

Your order must include:

• CPAP settings
• Humidifier and supplies
• Signed and dated by the ordering physician

3) Your Original Qualifying Sleep Study (If You’re New to You Can)

• If you’re new to You Can Home Medical, we may need the sleep study that qualified you for your last CPAP.

BiPAP / RAD Orders (If Applicable)

If your order is for RAD/BiPAP, please include:

• Diagnostic sleep study
• Titration study
• Any additional supporting documentation