CPAP masks, cushions, tubing and filters wear out. A cushion that has lost its shape leaks, and a clogged filter makes the machine work harder. In the US, the replacement schedule most people hear about comes from Medicare’s coverage policy. This guide explains what it says and what it costs to follow it yourself.
Medicare’s replacement schedule
The DME contractors’ LCD L33718 sets the “usual maximum amount of accessories expected to be reasonable and necessary”. Quantities above these are denied.
| Item | HCPCS | Usual maximum |
|---|---|---|
| Full face mask | A7030 | 1 per 3 months |
| Full face mask cushion (replacement) | A7031 | 1 per month |
| Nasal interface (mask or pillow type) | A7034 | 1 per 3 months |
| Nasal mask cushion (replacement) | A7032 | 2 per month |
| Nasal pillows (replacement, pair) | A7033 | 2 per month |
| Combination oral/nasal mask | A7027 | 1 per 3 months |
| Oral cushion / nasal pillows for combination mask | A7028 / A7029 | 2 per month |
| Tubing | A7037 | 1 per 3 months |
| Heated tubing | A4604 | 1 per 3 months |
| Filter, disposable | A7038 | 2 per month |
| Filter, non-disposable | A7039 | 1 per 6 months |
| Headgear | A7035 | 1 per 6 months |
| Chinstrap | A7036 | 1 per 6 months |
| Humidifier water chamber | A7046 | 1 per 6 months |
Frequencies are from LCD L33718. Item descriptions are from ResMed’s reimbursement guide and the Noridian DME article on nasal interfaces.
These are maximums Medicare will pay for, not instructions to throw parts away on a fixed date. If a part is damaged or no longer seals, replace it sooner, and follow your manufacturer’s cleaning and replacement instructions.
How Medicare resupply works
- You must qualify for the device. Accessories are covered when the coverage criteria for the PAP device are met (L33718). If you are still in the first 90 days, that means meeting the adherence rule.
- No automatic shipping. The supplier must contact you and document an affirmative response before each refill. It must not ship automatically on a set schedule, even if you agreed to that.
- Timing. The supplier can contact you no sooner than 30 calendar days before your current supply is expected to end, and can deliver no sooner than 10 calendar days before.
- Up to 3 months at a time. ResMed’s reimbursement guide says that, according to Medicare, a supplier must not dispense or bill more than a three-month quantity of accessories at once (ResMed).
- Owned machines. The same ResMed guide says CMS stated in 2016 that medical necessity for replacement accessories is established for a patient-owned PAP when Medicare paid for the base device through its 13 months of continuous use.
You pay the Part B coinsurance on each supply claim, as for the device itself (medicare.gov).
What the parts cost if you pay cash
List prices on ResMed’s US shop on 13 October 2026, before tax:
| Part | Price |
|---|---|
| AirFit P10 replacement pillows | $22 |
| AirFit N20 replacement cushion | $34 |
| AirFit F20 replacement cushion | $54 |
| AirFit P10 headgear | $28 |
| AirFit/AirTouch N20 headgear | $34 |
| AirFit/AirTouch F20 headgear | $34 |
| Standard air filters for Air11 devices | $9 (2-pack) or $29 (12-pack) |
| HumidAir standard water tub for Air11 | $31 |
| ClimateLineAir heated tubing for Air11 | $49 |
| SlimLine tubing | $37 |
| Complete masks (P10 / N20 / F20) | $105 / $105 / $155 |
Worked example: one year at Medicare’s maximum, AirSense 11 with AirFit F20
Using the prices above and the LCD’s usual maximums:
| Item | Per year at the maximum | Cost |
|---|---|---|
| F20 complete mask (1 per 3 months) | 4 | $620 |
| F20 cushions (1 per month; the 4 masks include cushions, so 8 extra) | 8 | $432 |
| Heated tubing (1 per 3 months) | 4 | $196 |
| Disposable filters (2 per month) | 24 = two 12-packs | $58 |
| Water tub (1 per 6 months) | 2 | $62 |
| Headgear | Included with each complete mask | $0 |
| Total | $1,368 |
That’s the most Medicare would usually pay for in a year, at ResMed’s list prices. Most cash payers replace parts less often. Replacing the mask and heated tubing every 6 months while keeping monthly cushions comes to $1,068 a year at the same prices. Retail discounts and subscription programs can cut it further: cpap.com, for example, advertises saving 10% on scheduled supply deliveries.
Signs a part needs replacing now
- The cushion is torn, sticky, or no longer seals at your pressure.
- The headgear has stretched and you’re tightening it to stop leaks.
- The tubing is cracked or has a hole.
- The filter looks discolored or clogged.
- The water chamber is cracked or cloudy and won’t come clean.
Verdict
Use Medicare’s schedule as the most you can claim, not a fixed calendar. If you’re on Medicare, reply when your supplier contacts you, because it can’t ship without your confirmation. If you pay cash, replace the cushion and filters most often, since they affect your seal and air quality most, and stretch the rest as long as they still work. If you have an HSA or FSA, see HSA/FSA eligibility.
For the cleaning routine that keeps parts lasting, see how to clean a CPAP.