[Provider] Clarification of 36-month Oxygen Limit

[Provider Notification]

Oxygen Providers - Clarification of Medicare 36-month limit 

 

The following comes from the Centers for Medicaid and Medicare Services' website, and explains the 36-month limit on oxygen equipment.  More Questions and Answers about Medicare's oxygen benefit <https://questions.medicare.gov/cgi-bin/medicare.cfg/php/enduser/std_alp.php?p_sid=nBZsi9uj&p_lva=&p_li=&p_accessibility=0&p_redirect=&p_page=1&p_cv=&p_pv=&p_prods=&p_cats=0&p_hidden_prods=&cat_lvl1=0&p_search_text=oxygen&p_new_search=1>  are available on-line.  

Q. How does Medicare pay for oxygen and oxygen equipment?

A. Medicare pays suppliers a monthly fee for furnishing all medically necessary oxygen and oxygen equipment, including accessories and supplies like tubing or a mouthpiece. Assuming that you have no unmet Part B deductible, Medicare pays 80 percent of the allowed amount and you pay 20 percent of the allowed payment amount.

After 36 months of continuous use, Medicare stops making rental payments for the oxygen equipment, but you will continue to get the oxygen equipment, accessories, and supplies from the same supplier at no charge until the end of the reasonable useful lifetime of the oxygen equipment (currently 5 years after the date that the equipment was delivered to you).

At the end of the equipment's reasonable useful lifetime, the supplier can pick up the equipment and you can get new equipment if it is determined that you still have a medical need for oxygen. When you get the new equipment, Medicare starts a new 36 month rental payment period. If you get liquid or gaseous oxygen delivered in tanks or cylinders, your supplier must continue to deliver replacement tanks or cylinders after the 36 month rental period ends, and Medicare will continue to pay for delivery of oxygen contents in these tanks and cylinders.

If you have more questions, feel free to contact MaineCare's Billing & Information line at 1-800-321-5557 Option #8.  

 

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