Oxygen and Oxygen Equipment

Medicare covers home oxygen and oxygen equipment when a qualifying blood gas study (ABG or oximetry) performed at the time of need meets defined physiologic thresholds and is conducted by a qualified provider, and when home oxygen is expected to improve the beneficiary's condition. Specific coverage groups: Group I (rest, sleep, or exercise hypoxemia thresholds), Group II (PO2 56–59 or sat 89% plus specified cardiopulmonary findings or hematocrit >56%), and Group III (non-hypoxemic conditions with peer-reviewed evidence) define eligibility; multiple testing, device, and documentation requirements (e.g., SWO/WOPD, POD, in-person testing, IDTF safeguards for home overnight oximetry) and exclusions (Group IV conditions, supplier-conducted tests, portable oxygen if only sleep-qualified, topical oxygen systems, and unbundled billing) apply.

"Initial coverage for home oxygen and oxygen equipment is reasonable and necessary only if the treating practitioner ordered and evaluated a qualifying blood gas study performed at the time of need,..."