Reimbursement Support

Get assistance with funding your eXciteOSA.

HCPCS codes: E0492, E0490, E0491, and E0493 became effective October 1, 2023.

Product Name
Model Number
HCPCS Code
EXCITEOSA STARTER KIT (mobile application) 13010 E0492
EXCITEOSA MOUTHPIECE replacement (mobile application) 16000 E0493
EXCITEOSA STARTER KIT (hardware remote) 18001 E0490
EXCITEOSA MOUTHPIECE replacement (hardware remote) 16000 E0491

Please have your DME supplier contact your health insurance company to verify coverage requirements and estimated out of pocket costs.

For direct reimbursement assistance, please use the Support Tools below.

Need help?  For any questions, please contact 844-MILDOSA or https://signifiermedical.com/contact/.

Commercial Payer Patients

Here you’ll find a complete set of resources dedicated to eXciteOSA® submissions to Commercial Payers.

 

View Downloads

Medicare Patients

Please use these templated materials and letters of medical necessity and appeals for Medicare

 

View Downloads

Medicaid Patients

Please use these templated materials and letters of medical necessity and appeals for Medicaid

 

View Downloads

Payer Summary Reference

Download

Letter of Medical Necessity

Download

Coverage Requirements

Download

Payer Summary Reference

Download

Letter of Medical Necessity

Download

Coverage Requirements

Download

Payer Summary Reference

Download

Letter of Medical Necessity

Download

Coverage Requirements

Download