Reimbursement Support Center
Our in-house team is here to assist with Inspire® therapy reimbursement needs
Most US insurance providers cover Inspire® therapy¹
Inspire Medical Systems provides resources to assist with coding, coverage, and payment for Inspire® therapy both pre-implant and post-implant.
Broad Private Insurance Coverage
Medicare Coverage Across The U.S.
Many VA And Military Hospitals
1 Data on file.
Payer Coverage
The Payer Access Library (PAL) serves as a guide for hospitals and physicians evaluating candidates for hypoglossal nerve stimulation with Inspire® therapy. With a single glance, clinicians can see whether a patient may meet the coverage criteria set by regional or national payers, and when a deeper review is needed, the PAL provides direct links to full payer policies.
Prior Authorization Support
Most sleep apnea patients who meet eligibility requirements for Inspire® therapy have access to insurance coverage. The process to obtain prior authorization can be complex, and can be a barrier to patient access to therapy. Inspire® therapy is willing to collaborate with you to assist with this process to obtain prior authorization for Inspire® therapy for suitable patients. For questions regarding prior authorization, please email the Inspire Prior Authorization team at [email protected].
Reimbursement Support
For questions or support with reimbursement coding, coverage, and payment (including billing and claim denials), please email the Inspire Reimbursement team at [email protected].
Coding & Billing Guides
Inspire V™ Hospital/ASC Billing Guide
Download this guide to easily find background information on payer coverage for implantable devices, as well as all the codes you’ll need, from Diagnosis codes and CPT® Procedure codes to Hospital Device codes for the Inspire V™ System.
Inspire IV Hospital/ASC Billing Guide
Download this guide to easily find background information on payer coverage for implantable devices, as well as all the codes you’ll need, from Diagnosis codes and CPT® Procedure codes to Hospital Device codes.
Inspire V™ Physician Billing Guide
Looking for background information on payer coverage, as well as Diagnosis codes, CPT® Procedure codes and billing for Medicare and private payers for the Inspire V™ System? Download this guide.
Inspire IV Physician Billing Guide
Looking for background information on payer coverage, as well as Diagnosis codes, CPT® Procedure codes and billing for Medicare and private payers? Download this guide.
Sleep Services Billing Guide
In this guide, you will find background information on payer coverage for programming devices, as well as proper Diagnosis and CPT® Procedure coding and billing for Medicare and private payers.
Remote Monitoring Reimbursement Guide
This guide contains the CPT® code resources needed to describe remote monitoring of the Inspire HGNS therapy. It includes the Category 1 CPT® codes for reporting the initial patient set-up and monthly monitoring.
Inspire is not for everyone. Talk to your doctor (or Talk to your patients) about risks, benefits and expectations associated with Inspire. Risks associated with the surgical implant procedure may include infection and temporary tongue weakness. In rare cases tongue paresis and atrophy may occur. Some patients may require post implant adjustments to the system’s settings in order to improve effectiveness and ease any initial discomfort they may experience. Important safety information and product manuals can be found at inspiresleep.com/safety-information , or call 1-844-OSA-HELP.