HCPCS code E0601: Continuous Positive Airway Pressure (CPAP) device

Read more on how to accurately use and bill for HCPCS code E0601 with the billing and documentation requirements in our short guide.

Use Code

Frequently asked questions

Benefit begins if: (1) there’s an in-person evaluation before sleep testing; (2) sleep study shows AHI/RDI ≥ 15 events/hour (or 5–14 with documented symptoms or comorbidities); and (3) patient/caregiver receives usage instruction.

Beginning with month four and thereafter, add KX modifier only if there’s documentation of a re-evaluation between day 31–91, clinical improvement, and PAP therapy adherence. Otherwise, claims should omit KX or be temporarily withheld until documentation is secured.

Medicare classifies E0601 as a capped rental item. After 13 months, the supplier may either provide a replacement PAP device or the supplier may purchase the device (depending on policy), but cannot continue rental billing.