MedicaidCoverageHigh impact
COVID-19: CPAP and NiPAP/Sleep Studies Criteria
Missouri Medicaid (MO HealthNet)·MO · Sleep Medicine, Pulmonology·Provider Notice
Effective date
Apr 1, 2020
We identified it
Jun 20, 2026
Summary
Due to COVID-19, MO HealthNet (Missouri Medicaid) will temporarily cover non-facility sleep studies and waive the requirement for facility-based sleep studies before approving CPAP/BiPAP equipment. Pre-certification is still required for all CPAP/BiPAP equipment.
Action Required
Immediately: Billing team can now submit claims for non-facility sleep studies (CPT 95800, 95801, 95806) to Missouri Medicaid without facility requirements. For CPAP/BiPAP equipment (E0601, E0470, E0471), providers must still call DME Pre-Certification Hotline at 800-392-8030 option 2 for pre-authorization, but no longer need to complete facility-based sleep studies first. Update billing workflows to reflect these temporary coverage expansions.