HCPCS Code A7030: Full Face Mask Used With Positive Airway Pressure Device (PAP), Each

Yes, but each code must be billed appropriately. A7030 covers the full-face interface; nasal masks (A7034), replacement cushions (A7031, A7032), and headgear (A7035) are billed separately and follow their own replacement schedules. Make sure that the medical necessity for each interface type is clearly documented. Payers may review whether usage of both interfaces is clinically justified and meets applicable criteria for coverage.

You must provide strong clinical justification, such as mask failure, patient-specific comfort needs, or skin breakdown. Suppliers should maintain a documented refill request from the patient, including confirmation of existing supplies and whether they are approaching exhaustion. In addition, keep POD, SWO, and clinical notes that explain why replacement before the standard frequency is needed. LCDs and payer rules may impose stricter reviews, so ensure that the criteria for early replacement are fully met and supported by documentation.

No. The A7030 full-face mask includes its cushion/pillows as part of its features. Billing them separately would be considered duplicate billing and will not be reimbursed. Only replacement cushions for nasal or full-face masks (e.g., A7031, A7032) should be billed when applicable.