All PlansCoverageMedium impact
05.00.30p, Noninvasive Respiratory Assist Devices (RADs): Continuous Positive Airway Pressure (CPAP) Devices, Auto-Adjusting Positive Airway Pressure (APAP) and Bi-Level Devices
Independence Blue Cross·Pulmonology, Sleep Medicine·Medical Policy
Effective date
Oct 29, 2025
We identified it
Jun 19, 2026
Summary
Policy 05.00.30p regarding Noninvasive Respiratory Assist Devices (CPAP, APAP, and Bi-Level devices) has been reissued effective 10/29/2025. Without access to the full policy content, the specific changes cannot be determined; however, billing teams must review this updated guidance immediately to identify any changes to coverage criteria, prior authorization requirements, billing codes, or documentation standards for respiratory assist device claims.
Action Required
By 11/15/2025: Billing team must obtain and review the complete text of policy 05.00.30p from the provided URL (https://medpolicy.ibx.com/ibc/Commercial/Pages/Site-Activity-View.aspx?FilterField1=MPSiteActivityLogMonth&FilterValue1=10&FilterField2=MPSiteActivityLogYear&FilterValue2=2025#commercial-05-00-30p). Document any changes to: (1) covered respiratory assist device types and models, (2) prior authorization requirements, (3) applicable billing codes (CPT/HCPCS), (4) medical necessity documentation requirements, and (5) coverage limitations. Update billing software, encounter forms, and prior authorization protocols accordingly. Communicate changes to providers and clinical staff. Failure to implement required updates may result in claim denials for respiratory assist device claims submitted after the effective date.