Question:

How does Medicare pay for oxygen and equipment?

Answer:

Medicare pays a monthly fee schedule amount for oxygen and oxygen equipment per beneficiary. For stationary oxygen equipment, this fee covers the oxygen equipment, contents and supplies and is subject to adjustment depending on the amount of oxygen prescribed (liters per minute [LPM]) and whether or not portable oxygen is also prescribed.

The payment rules regarding adjustments to the monthly payment amounts for oxygen and oxygen equipment based on the patient’s prescribed oxygen flow rate can be found in the Medicare Claims Processing Manual, Chapter 20, Section 30.6.1 at https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c20.pdf.

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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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