Noninvasive Positive Pressure Ventilation (NIPPV) in the Home for the Treatment of Chronic Respiratory Failure (CRF) Consequent to Chronic Obstructive Pulmonary Disease (COPD)

CMS nationally covers home RADs (with or without backup) and volume‑targeted HMVs for chronic respiratory failure due to COPD when patients have PaCO2 ≥ 52 mmHg awake on prescribed FiO2, sleep apnea is not the predominant cause, and device‑specific clinical criteria are met; initial coverage is 6 months. Continued coverage requires objective device use ≥ 4 hours/day on ≥ 70% of days plus documented clinical benefit or stabilization, with specific HMV indications (e.g., FiO2 ≥ 36% or ≥4 L/min, >8 hours ventilatory support, need for alarms/battery) or clinician justification that RAD cannot meet needs.

"RAD with backup rate feature is covered in the home for an initial 6-month period for patients with COPD who have PaCO2 ≥ 52 mmHg on arterial blood gas during awake hours while breathing prescribed..."

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