I ran across this post at apneasupport.com in response to someone questioning whether anyone had ever been successful in getting Medicare reimbursement for an oral appliance for OSA.

19 Feb 2010

New patient exam and evaluation or existing patient exam and evaluation may be billed separately using the CPT codes appropriate for the visit. Requires treating physician letter or Rx, specifying the appliance name and manufacturer.

For Provider submitted claims to Medicare
If the provider is billing on behalf of the patient, they must use a CMS 1500 form. Claim Forms Plus provides online ordering of CMS (HCFA) 1500 08/05 Claim Forms. This is the 08/05 version and it is approved OMB-0938-0999 FORM CMS-1500. These forms may be purchased on-line through Office Max or Staples or any medical supplier.

If the patient is billing Medicare directly
Patient’s Request for Medical Payment form (CMS 1490S). along with instructions for completing it, and where to return the form for processing are located on-line at: http://www.cms.hhs.gov/cmsforms/downloa ... ns-DME.pdf

Please send the completed claim form, your itemized bill, and any supporting documents to the Medicare contractor and explain in detail your reason for submitting the claim.

The address where you need to return the form for processing depends on the state you live. If your provider or supplier refused or is unable to file a claim for a Medicare-covered item or not enrolled with Medicare, you must include a statement that your provider or supplier refused to do so. Very few dentist are currently enrolled with Medicare. If this statement is not included, the Medicare contractor will return your CMS 1490S form and you will need to complete another claim form with the statement included.

When you submit your own claim to Medicare, complete the entire form. Medicare contractors will reject the claim or will send a letter to you with an explanation of why it was returned if the form is incomplete. You should mail the original claim form and make copies for your records. Please allow at least 60 days for Medicare to receive and process your request.
If you have any other questions, please feel free to call 1-800-MEDICARE (1-800-633-4227).

Use the following address table to ensure the correct address will be provided on the 1490S claim.

If you live in: Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont (Region A)
Return your form to: NHIC, Corp.
P.O. Box 9180
Hingham, MA 02043-9180

If you live in: Illinois, Indiana, Kentucky, Michigan, Minnesota, Ohio, Wisconsin (Region B) Return your form to: National Government Services, Inc.
DMEPOS Operations Medicare
DMEPOS Claims P.O. Box 7027
Indianapolis, IN 46207-7027

If you live in: Alabama, Arkansas, Colorado, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Oklahoma, Puerto Rico, South Carolina, Tennessee, Texas, U.S. Virgin Islands, Virginia, West Virginia (Region C)
Return your form to: CIGNA Government Services
P.O. Box 20010
Nashville, TN 37202-0010

If you live in: Alaska, American Samoa, Arizona, California, Guam, Hawaii, Idaho, Iowa, Kansas, Missouri, Montana, Nebraska, Nevada, North Dakota, Northern Mariana Islands, Oregon, South Dakota, Utah, Washington, Wyoming (Region D) Return your form to: Noridian Administrative Services
P.O. Box 6727
Fargo, ND 58108-6727

I suspect some of these addresses might be out-of-date so double check before mailing.