Filing for Insurance

To file for insurance coverage you must first be diagnosed with Obstructive Sleep Apnea. The appropriate diagnostic code (ICD 9) is 327.23.

The TAP is a medical device. All insurance claims should be filed under your medical plan. The TAP® has been categorized as Durable Medical Equipment (DME) by CMS (Medicare) and subsequently private insurance carriers recognize this as well.

The appropriate billing code is E0486, which is a HCPCS code that uses the following description: "ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR NON-ADJUSTABLE, CUSTOM FABRICATED,INCLUDES FITTING AND ADJUSTMENT.

Some private insurance carriers require that you are intolerant to or have failed Continuous Positive Airway Pressure (CPAP). When this is the case, you will need a Letter of Medical Necessity from your treating physician that documents your inability to use CPAP and your need for an Oral Appliance. Click here for a printable sample letter in PDF format.

Please check with your insurance carrier for specific coverage benefits and reference billing code: E0486.

Most commercial insurance companies are currently requiring that you have either failed Continuous Positive Airway Pressure (CPAP) or are unable to tolerate an attempt. It is necessary to obtain a letter of referral documenting your inability to use CPAP and an Rx for the TAP^® from your treating physician. This letter can be from your primary care physician, a treating specialist in any discipline or sleep specialist. Click here for a printable sample letter in PDF format.