CMS Expands O2 Coverage

BALTIMORE–CMS will expand Medicare home oxygen coverage
criteria for beneficiaries enrolled in a CMS-approved clinical
trial.

Under a final national coverage determination released last
week, home oxygen will be covered for beneficiaries with arterial
oxygen partial pressure measurements from 56 to 65 mmHg or oxygen
saturation at or above 89 percent. These beneficiaries must be
participants in a clinical trial sponsored by the National Heart,
Lung & Blood Institute.

“This is an important opportunity to improve the care of our
seniors, and to get better evidence on how doctors and patients can
achieve the best outcomes for this serious and hard to treat
condition,” said CMS Administrator Mark McClellan.

Medicare currently provides coverage for home oxygen for
beneficiaries with partial pressure measurements at or below 55
mmHg or oxygen saturation at or below 88 percent. If certain other
diseases/conditions are present, coverage is provided for patients
with an oxygen partial pressure of 56 to 60 mmHg or an oxygen
saturation of 89 percent.

To view the decision memo, click
here.

The list of covered clinical trials will be available at
www.cms.hhs.gov/center/coverage.