How to Fill Out and Submit the Apria DME Order Form

The Apria DME order form is a physician-initiated document that captures patient demographics, insurance details, the prescribed device with its settings, and the clinical justification for it; once completed and signed, it goes to Apria by fax at (888) 492-0010, through the online portal, or through an integrated EHR system.¹ Three things decide whether the order moves or stalls: correct insurance information, a qualifying diagnosis with supporting test results, and a physician signature tied to the right NPI.

What to Gather Before You Start

Filling in the form is mostly transcription. Scrambling for a missing policy number or diagnosis code mid-form is where delays start, so pull everything together first.

Patient demographics. Full legal name spelled exactly as it appears on the insurance card, date of birth, home address, and primary and secondary phone numbers for delivery coordination. Include the Medicare Beneficiary Identifier (MBI) if the patient has one.
Insurance information. Carrier name, group number, and policy ID from the benefit card. Pull the secondary card too if there is one; skipping secondary coverage means Apria cannot coordinate benefits and the patient can end up with a larger bill than expected.
Physician details. The treating practitioner’s full name and 10-digit National Provider Identifier, plus a direct clinic phone number so Apria’s intake team can resolve small issues without returning the whole document.²
Diagnosis code. The ICD-10 code that matches the condition. G47.33, for example, identifies obstructive sleep apnea.³
Equipment specifics. The exact device (CPAP, stationary oxygen concentrator, wound therapy unit), prescribed settings (liters per minute for oxygen, pressure settings for PAP), duration of use, and accessories needed at initial delivery such as masks, tubing, or filters.
Clinical test results. The documentation that proves medical necessity: sleep study results for CPAP, arterial blood gas or pulse oximetry readings for oxygen.

Clinical Documentation the Order Must Rest On

The form itself is only half the paperwork. Behind it sits the clinical record that justifies the equipment. Without it, the insurer denies the claim and nothing ships.

Face-to-Face Encounter

For many DME categories, Medicare requires a face-to-face examination with the treating practitioner within six months before the order date.⁴ The visit must document that the practitioner evaluated or treated the condition supporting the request. As of April 2026, 83 items — including oxygen systems, power mobility devices, and hospital beds — appear on the CMS list requiring both a face-to-face encounter and a written order before delivery.⁵ For items not on that list, the written order still has to reach the supplier before the claim is submitted, just not necessarily before delivery.

The practitioner who signs the order does not have to be the one who performed the face-to-face visit, but they must verify the visit occurred within the six-month window and have access to the documentation.⁴

Qualifying Tests for Oxygen

Home oxygen orders require documented hypoxemia. Medicare’s criteria: PaO2 at or below 55 mm Hg, or arterial oxygen saturation at or below 88%, measured at rest on room air. A second coverage group applies to patients with PaO2 between 56 and 59 mm Hg (or saturation of 89%) who also have congestive heart failure with dependent edema, pulmonary hypertension, or hematocrit above 56%.⁶ The qualifying test, arterial blood gas or pulse oximetry, must be performed at the time of need. When both are done and conflict, Medicare defers to the arterial blood gas.

Sleep Study for CPAP

Medicare covers a 12-week initial trial of CPAP therapy for patients diagnosed with obstructive sleep apnea. After the trial, an in-person follow-up with the practitioner must document that therapy is working and that certain conditions are met. Medicare then continues paying rental costs for up to 13 months of uninterrupted use.⁷ The sleep study documenting OSA, with the titrated pressure settings, needs to accompany the order.

Filling In the Form

With documentation assembled, the form itself is transcription work. Accuracy here prevents delays that push delivery back by weeks.

Start with the demographic block at the top. Spell the patient’s name exactly as it appears on the insurance card. A one-letter mismatch can trigger a rejection. Enter the date of birth, address, phone numbers, and the MBI if applicable.

Move to insurance. Enter the primary carrier’s name, group number, and policy ID. Add any secondary coverage. Compare every digit against the card.

The clinical section is where most orders get tripped up. CMS requires six elements on every written order: the beneficiary’s name or MBI, a description of the item, the quantity ordered, the treating practitioner’s name or NPI, the date of the order, and the practitioner’s signature.⁵ Enter the ICD-10 diagnosis, the specific equipment with its prescribed settings, and the anticipated duration of use. For oxygen, include the flow rate in liters per minute. For PAP devices, include the pressure settings from the titration.

Check every box for accessories the patient needs at initial setup: masks, cushions, tubing, filters, humidifier chambers. Any field marked required (often flagged with an asterisk) is a guaranteed bounce-back if left blank. The physician signs and dates the bottom. Confirm the NPI on the form matches the signing practitioner. An NPI that does not match the signature is one of the most common reasons for rejection, and it happens constantly when a nurse practitioner or physician assistant writes the order but a supervising physician’s NPI gets entered instead.

Submitting the Order

Apria accepts orders through several channels. The fastest is faxing the completed form with the supporting clinical documentation to the prescription fax line at (888) 492-0010.¹ Some physician offices use electronic health record systems that integrate with Apria’s intake workflow, which cuts transcription errors. Existing patients can manage supply reorders through the portal at my.apria.com, though that channel is for reorders rather than initial prescriptions.⁸ To discuss an order or check status, Apria’s main number is (888) 492-7742. Standard mail works but adds several business days.

What Happens After You Submit

The intake team reviews the form for completeness, then contacts the patient’s insurer to verify coverage and determine whether prior authorization is required. If pre-authorization is demanded, expect additional waiting time while the request moves through the payer’s review, which can run from a few days to a couple of weeks depending on the insurer. A representative typically reaches out to the patient to discuss order status, coordinate delivery, and clarify copayments or deductibles.

Once verification and any authorization clear, Apria schedules delivery. A technician brings the equipment to the home, sets it up, and walks the patient through operation, filter maintenance, and when to call for service. The patient or a designee signs a proof-of-delivery document confirming receipt.

That signature is not a formality. It is a Medicare compliance requirement that Apria must retain for seven years. The slip must list the beneficiary’s name, delivery address, item description, quantity, delivery date, and the signature of the beneficiary or a designee. A designee can be a spouse, family member, or neighbor; the relationship must be noted, and an illegible signature must be printed alongside. Nobody employed by the supplier, or with a financial interest in the delivery, can sign on the patient’s behalf.⁹

Why Orders Get Bounced

The frequent reasons orders stall come down to preventable paperwork gaps.

NPI mismatch. The NPI on the order does not match the signing physician. Common when a mid-level provider writes the order but a supervising physician’s NPI is entered.
Missing face-to-face documentation. The visit may have happened, but if the documentation does not accompany the order, intake treats it as if it did not.
Incomplete written order. Skip any one of the six CMS-required elements and the order is incomplete.⁵
Insurance data errors. A transposed digit in a policy number, or a name that does not match the insurer’s records, bounces the claim. Compare the form to the card character by character.
Insufficient clinical justification. For oxygen, the qualifying blood gas or oximetry results must be included. For CPAP, the sleep study must document OSA. Submitting without them forces Apria to request them separately, adding days or weeks.

A DME claim that misrepresents medical necessity or includes false information carries consequences beyond a simple denial. The federal False Claims Act imposes penalties of up to three times the program’s loss plus over $11,000 per false claim filed.¹⁰ A few extra minutes checking the form against the documentation is worth it.

1
Apria. Contact Us – Apria Healthcare
2
Centers for Medicare & Medicaid Services. National Provider Identifier Standard (NPI)
3
ICD10Data.com. ICD-10-CM Diagnosis Code G47.33
4
Noridian Healthcare Solutions. Face-to-Face and Written Order Requirements for Certain Types of DME
5
Centers for Medicare & Medicaid Services. DMEPOS Order and Face-to-Face Encounter Requirements
6
Centers for Medicare & Medicaid Services. Oxygen and Oxygen Equipment
7
Medicare.gov. Continuous Positive Airway Pressure (CPAP) Therapy
8
Apria. Sign In to Order Supplies – Apria Healthcare
9
Noridian Medicare. Proof of Delivery
10
Office of Inspector General. Fraud and Abuse Laws