CNY Dental Sleep Now Accepts Medicare: Expanding Access to Oral Appliance Therapy for Sleep Apnea

To our colleagues at SUNY Upstate, Crouse Health, and St. Joseph’s Hospital:

We’re pleased to announce that CNY Dental Sleep is now a participating Medicare provider for the treatment of obstructive sleep apnea (OSA) with oral appliance therapy (OAT).

This change allows us to expand access to effective, evidence-based care for patients who are CPAP-intolerant, particularly those with mild to moderate OSA, or those who cannot tolerate or comply with PAP therapy despite best efforts.

As you know, adherence is the Achilles’ heel of CPAP therapy. Studies have consistently shown long-term compliance rates below 50%, and many patients discontinue use within the first year. For this population, oral appliance therapy is no longer a second-line option—it’s a proven, guideline-supported alternative, particularly when delivered by a qualified dentist trained in dental sleep medicine.

At CNY Dental Sleep, we specialize exclusively in oral appliance therapy for sleep-disordered breathing. Our approach is grounded in current American Academy of Dental Sleep Medicine (AADSM) and American Academy of Sleep Medicine (AASM) guidelines. Each device is custom-fabricated, titrated, and followed with objective outcomes monitoring—either via follow-up sleep testing or embedded compliance/tracking technology depending on the device.

We collaborate closely with referring sleep physicians and primary care providers to ensure a multidisciplinary, continuity-based care model. Our process includes:

• Verification of Medicare coverage and benefits

• Fabrication of FDA-cleared, custom oral appliances

• Follow-up for titration, fit, comfort, and long-term efficacy

• Reports sent directly to your office for follow-up and documentation

• Coordination with DME providers or sleep labs as needed

  
  

Now that we are in-network with Medicare, we can reduce the financial barrier for older patients who may have previously foregone treatment due to out-of-pocket costs. For qualified patients, Medicare covers oral appliance therapy under HCPCS code E0486, assuming standard documentation criteria are met (diagnosis via PSG or HST, charted CPAP intolerance or refusal, and prescription by a physician).

If you have patients who are CPAP-intolerant, or who are searching for an alternative to nightly positive pressure, we’re ready to help. Referrals can be sent via fax, EMR message, or phone. We also welcome direct communication if you have questions about case suitability, insurance logistics, or device types.

Thank you for your continued trust in our care. We’re proud to partner with you to improve sleep quality, reduce cardiovascular risk, and support better long-term outcomes for patients across Central New York.