Q:

What is the policy for coverage of oxygen therapy through Medicare?

A:

Quick Answer

Medicare provides coverage for home oxygen therapy equipment under the durable medical equipment benefit, states the Centers for Medicare & Medicaid Services. It provides services for patients with severe hypoxemia but requires medical documentation, laboratory testing and the patient trying other treatments without success. Part B doesn't cover respiratory therapists.

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Full Answer

While Medicare recognizes that home oxygen therapy is the only option for some patients, it also requires delaying the use of the therapy as long as possible by using other types of treatment, according to the Centers for Medicare & Medicaid Services. The attending physician, his employee or another clinical therapist must complete the form showing the therapy is a medical necessity, and the physician must sign it. Medicare rules prohibit the durable medical equipment supplier from completing the form. Medicare also requires documentation showing the diagnosis of a disease requiring oxygen therapy, the flow rate the physician is prescribing and the frequency and duration of its use. Patients who are mobile and receive approval for home oxygen therapy may also qualify for portable oxygen therapy devices.

Medicare does not cover oxygen therapy for terminal illnesses not affecting the lungs, conditions that do not result in hypoxemia, or severe peripheral vascular disease, according to the Centers for Medicare & Medicaid Services. With these conditions, oxygen therapy is not helpful, may be harmful, or other treatments are more effective at improving the condition.

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