Dentists Become Durable Medical Equipment Suppliers for Sleep Apnoea Oral Appliances

dentistsSleep apnoea is becoming more of a common disorder and this has caused many companies to develop devices to treat this problem. Recently, dentists are placing orders for custom oral appliances for Obstructive Sleep Apnoea (OSA). This is because the majority of medical insurance companies now cover Oral Appliance Therapy (OAT). Improved reimbursement for OAT started on 3 January 2011, when Medicare approved reimbursement for sleep apnoea oral appliances.

An article from has explained how sleep apnoea oral appliances get covered now by Medicare.

  • Medicare, the federal system of health insurance for people over 65 and some individuals with disabilities, had effectively endorsed oral appliances as an accepted treatment for OSA, a very serious condition. Since then, commercial carriers have stepped up by allowing medical insurance coverage for oral appliances.

  • Medicare’s groundbreaking decision — to allow dentists to receive reimbursement — has helped many seniors and health insurance beneficiaries receive treatment for OSA.

  • Since there is no dental code for oral appliances, these devices are billed through the patient’s medical insurance or Medicare.

  • For Medicare to cover oral appliances for OSA, specific criteria must be met.

  • To become eligible to bill Medicare for OAT, dentists must apply to become a Medicare Durable Medical Equipment (DME) supplier.  Once you become a DME supplier, a Medicare approved appliance must be used.  Some commercial carriers have required that dentists have a Medicare DME supplier license in order to receive reimbursement.

  • Medicare announced that prefabricated appliances are not covered and only a licenced dentist can bill for custom oral appliances.

  • Medicare does not reimburse for TMJ/TMD appliances under DME.

  • The beneficiary must have a face-to-face clinical evaluation by the treating physician prior to a sleep test.

  • Medicare requires a physician written order (Rx) for an oral appliance.

  • Commercial carriers have set policies that may be similar to, or differ from, Medicare’s policy.

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Somnowell Inventor - Visiting Professor Simon Ash FDS MSc MOrth BDS

Prof. Ash is the inventor of the highly successful SOMNOWELL Chrome device for snoring and sleep apnoea.

The Somnowell Chrome is made to exacting standards in the Somnowell laboratory under the supervision of Visiting Professor Simon Ash. Prof. Ash and his master technicians create each Somnowell Chrome device using their wealth of experience and expertise.

Prof. Ash works at the forefront of his profession. He is a Consultant and Specialist Orthodontist with over 30 years clinical experience, with a special interest in sleep related breathing disorders, TMJD, and bruxism. He currently works in Harley Street London and two private hospitals in London as part of a multi-disciplinary team managing snoring and sleep apnoea, and is Visiting Professor of Orthodontics at the BPP University.