CPT 94660: CPAP Initiation and Patient Training
Medicare pays $72 and commercial payers pay $169 on average nationally for this procedure.
CPT code 94660 describes initiation of continuous positive airway pressure (CPAP) ventilation with patient training and management, a therapeutic respiratory procedure typically provided in an outpatient sleep clinic, pulmonary clinic, or hospital respiratory therapy setting to address sleep-disordered breathing such as obstructive sleep apnea and related breathing disturbances during sleep.
For related coverage guidance, see recent payer policy updates: Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure, Bronchial Valves, Pulmonary Arterial Hypertension Endothelin Receptor Antagonists.
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National Reimbursement Benchmarks
Commercial averages for CPT 94660 sit noticeably above Medicare: Blue Cross Blue Shield’s mean of $243 contrasts with Medicare’s mean of $71.6, and BUCA’s mean commercial rate of $169.4 also exceeds Medicare by roughly $97.8. This gap highlights commercial payers generally reimbursing at materially higher mean levels than the Medicare locality average for this code.
Dispersion varies across payers: Blue Cross Blue Shield shows the widest interquartile spread with P75−P25 = $282.90−$201.80 = $81.10, indicating substantial variability within that commercial book of business. UnitedHealth Group and Cigna have moderate spreads of $109.30−$56.00 = $53.30 and $100.90−$49.00 = $51.90 respectively. Aetna is the tightest with P75−P25 = $61.00−$34.00 = $27.00, suggesting more concentrated reimbursement levels for that insurer.