MedicaidAdministrativeMedium impact
CPAP Criteria
Missouri Medicaid (MO HealthNet)·MO · Sleep Medicine, Pulmonology, Family Medicine +1 more·Provider Notice
Effective date
Oct 31, 2023
We identified it
Jun 20, 2026
Summary
CPAP pre-certification process has been streamlined - providers no longer need to call the DME Helpdesk for overrides when a home sleep study is performed. The home sleep study criteria are now integrated directly into CyberAccess for automated DME pre-certification.
Action Required
Immediately: Billing team and providers should stop contacting the DME Helpdesk for CPAP overrides when home sleep studies are performed. Use CyberAccess system directly for DME pre-certification. Review the updated CPAP criteria document and unattended sleep study bulletin at the provided links to understand new automated criteria.