CMS Talks Travel Oxygen
Last week, the Centers for Medicare & Medicaid Services (CMS) DME MACs released clarification on travel oxygen, reminding providers that a new payment policy went into effect Jan. 1.
The clarification addressed short-term travel (days or weeks) or temporary relocation (snowbirds) outside of the provider's service area.
The memo stated:
- If the beneficiary travels or relocates outside the supplier's service area, then for the remainder of the rental month for which it billed, the home supplier must provide oxygen or arrange for a temporary supplier (non-billing) to provide oxygen.
- For subsequent rental months that the beneficiary is outside the service area, the home supplier can either provide or arrange for oxygen itself or assist the beneficiary in finding a temporary supplier (billing) in the new location.
- If the home supplier provides oxygen to the patient for use out-of-area or arranges for a temporary supplier (non-billing) to provide oxygen, the home supplier bills for whatever system the patient is using on the anniversary date/billing date. The supplier may provide the patient with different oxygen equipment (such as a portable concentrator) for travel, if there is an order from the physician.
- The home supplier may not bill for or be reimbursed by Medicare if it is not providing oxygen or has not arranged for a temporary supplier (non-billing) to provide oxygen on the anniversary billing date.
Claims from a billing temporary provider will be paid only if the claim is for a month in which the home supplier has not already billed Medicare.
The memo also stated: "If the beneficiary returns home before the end of a rental month for which the temporary supplier has billed, it must provide oxygen itself for the entirety of that month or make arrangements with the home supplier to provide the oxygen."
Temporary suppliers (billing) must provide a copy of a valid CMN, an order (if the order information was not included on the CMN), a report of the qualifying blood gas study and documentation of any required physician visit if requested.
If the beneficiary has reached the 36th month, suppliers must provide oxygen to the patient either directly or by arranging oxygen with a temporary supplier. Neither suppliers can bill for oxygen in months 37-60.
Additionally, CMS clarified that oxygen services furnished by airlines are not covered and are the responsibility of the beneficiary. CMS does not cover beneficiaries traveling or relocating outside of the United States. Therefore, providers are not required to provide or arrange oxygen services outside of the United States.