Chest
Topics in Practice ManagementLong-term Oxygen Therapy
Section snippets
Competitive Bidding
CMS, as required by federal law, has begun implementing the Medicare National Competitive Bidding Program for durable medical equipment (DME).13 This category includes home oxygen-delivery devices and related supplies. Simply stated, CMS will only reimburse LTOT suppliers who submit the most cost-effective bids for delivery of a minimum standard of service as defined by CMS. The “roll out” in metropolitan service areas is occurring currently in 10 selected cities and will then be expanded
Capped Rental
The congressionally mandated Medicare National Capped Rental Program for Oxygen16 is in effect. Under the current law, CMS stops payments to homecare suppliers after the 36th month of patient use (rental). After the 36-month payment cap, the homecare supplier must continue to provide any needed oxygen supplies without additional reimbursement. This period begins at month 37 and continues through month 60. CMS will pay limited additional reimbursement for emergency and periodic repairs until the
Clinical Considerations
The physician reimbursement structure for LTOT is unchanged and falls under the 2010 Current Procedural Terminology guidelines and related fee structures. The codes have been used in the direct face-to-face management of patients with other chronic diseases and disorders resulting in hyperglycemia, hypertension, and hyperlipidemia, which in many ways are analogous to chronic hypoxemia.
It has been shown that a prescribed continuous use of supplemental oxygen improves survival9 and some
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Collateral damage
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For editorial comment see page 238
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