Medicare Resupply Guidelines
2 PER / MONTH
DISPOSABLE FILTERS, A7038
FULL FACE CUSHION, A7031
NASAL MASK CUSHION, A7032
NASAL PILLOW CUSHION, A7033
ORAL CUSHION, A7028
EVERY 3 MONTHS
ENTIRE FULL FACE MASK, A7030
ENTIRE NASAL MASK (includes nasal pillow mask), A7034
TUBING, A7037
W/ HEATED COMPONENT, A4604
EVERY 6 MONTHS
HEADGEAR, A7035
CHINSTRAP, A7036
NON-DISPOSABLE FILTERS, A7039
HUMIDIFIER CHAMBER, A7046
Medi-Cal Resupply Guidelines
MONTHLY
DISPOSABLE FILTERS, A7038 - (2 per month)
NASAL MASK CUSHION, A7032 - (1 per month)
NASAL PILLOW CUSHION, A7033 - (2 pairs per month)
ORAL CUSHION, A7028 - (1 per month)
EVERY 6 MONTHS
ENTIRE NASAL MASK (includes nasal pillow mask), A7034
TUBING, A7037
W/ HEATED COMPONENT, A4604
HEADGEAR, A7035
CHINSTRAP, A7036
NON-DISPOSABLE FILTERS, A7039
HUMIDIFIER CHAMBER, A7046
EVERY 12 MONTHS
ENTIRE FULL FACE MASK, A7030