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 month, 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 diseases/conditions are present, coverage is provided for those with an oxygen partial pressure of 56 to 60 mmHg or an oxygen saturation of 89 percent.
