Medicare oxygen equipement service coverage

Oxygen and Oxygen Equipment

For stationary and portable oxygen equipment furnished on or after January 1, 2006, a 36-month cap applies on monthly payments. A listing of the applicable HCPCS codes is available in Chapter 5 of the Supplier Manual.

For stationary and portable oxygen equipment and oxygen contents furnished prior to January 1, 2006, payments were made for the duration of use of the equipment when medically necessary.
Contractors began the 36-month count on January 1, 2006, for beneficiaries that were receiving oxygen therapy prior to January 1, 2006. Months prior to January 1, 2006, are not included in the 36-month count.

On the first day after the 36th month anniversary for which payment has been made, the supplier must transfer the title for the stationary and/or portable oxygen equipment to the beneficiary. On that same day, the title for the equipment is transferred to the patient and monthly payments can begin to be made for oxygen contents used with patient owned gaseous and liquid oxygen equipment.

Modifiers appropriate for oxygen and oxygen equipment are:

•    RR Rental
•    QE Use if the prescribed amount of oxygen is less than 1 LPM
•    QF Use if the prescribed amount of oxygen exceeds 4 LPM and portable oxygen is prescribed
•    QG Use if the prescribed amount of oxygen is greater than 4 LPM
•    QH Use if an oxygen conserving device is being used with an oxygen delivery system

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