CMS Proposes Expansion of O2 Coverage

BALTIMORE–CMS has issued a preliminary decision that would
expand Medicare coverage criteria for home oxygen.

After considering the issue for several months, the agency
concluded home oxygen is “reasonable and necessary” for Medicare
beneficiaries with arterial oxygen partial measurements from 55 to
65 mm Hg or whose oxygen saturation is at or above 89 percent.

Current policy, which has been in effect since 1993, covers
beneficiaries with arterial oxygen partial measurements at or below
55 mm Hg or whose oxygen saturation is at or below 88 percent.

The agency’s proposal includes issuing a national coverage
determination to cover beneficiaries meeting the new criteria who
are enrolled in clinical trials identified by CMS and sponsored by
the National Heart, Lung & Blood Institute.

CMS is seeking public comment before making its final decision.
To view the proposed decision memo and submit comments, click
here.