Medicare local coverage
Medicare coverage for Surgical Treatment of Obstructive Sleep Apnea (OSA) (LCD)
One Medicare Administrative Contractor, WPS Insurance Corporation, publishes a local coverage determination (LCD) for Surgical Treatment of Obstructive Sleep Apnea (OSA). The snapshot lists 1 LCD record: 1 active.
An LCD applies only in the jurisdiction of the contractor that wrote it. Two contractors can cover the same service with different criteria, documentation requirements and covered diagnoses, so check the LCD from the contractor that processes your claims.
LCDs by contractor
| Contractor | LCD | Status | Last updated |
|---|---|---|---|
WPS Insurance CorporationMAC - Part A, MAC - Part B | L34526 | Active | Jun 16, 2025 |
An LCD marked Future has been finalized and is in its notice period; it applies from the effective date shown. LCD IDs link to the record on cms.gov.
Billing and coding articles
The codes live in the billing and coding article that goes with each LCD: the CPT and HCPCS codes the policy applies to, the ICD-10 codes that support medical necessity, and any modifier or documentation rules.
- A56905WPS Insurance CorporationUpdated Jan 22, 2026
Check claim lines against Medicare coverage
Coverage Check tells you whether a claim's diagnoses support Medicare LCD or NCD coverage for each procedure line, and shows the policy and CMS source behind each answer.
Related LCD topics
- Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea
- Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea
- Oral Appliances for Obstructive Sleep Apnea
- Positive Airway Pressure (PAP) Devices for the Treatment of Obstructive Sleep Apnea
- Bariatric Surgical Management of Morbid Obesity
- Blepharoplasty, Blepharoptosis Repair and Surgical Procedures of the Brow
All Medicare LCD topics · National coverage determinations · Payer policies by payer
Source: CMS Medicare Coverage Database, via the public CMS Coverage API, snapshot Oct 25, 2026. LCDs change between snapshots; confirm the version in effect for your date of service on cms.gov before billing.