10/28/2021

Oxygen and Oxygen Equipment Local Coverage Determination L33797 and Related Policy Article A52514 Update

Joint DME MAC Article Posted October 28, 2021

On September 27, 2021, the Centers for Medicare and Medicaid Services' (CMS) final Decision Memo announced the revision of National Coverage Determination (NCD) 240.2 – Home Use of Oxygen, and removed NCD 240.2.2 – Home Oxygen Use to Treat Cluster Headache (CH). Following the issuance of these policy changes, the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) are in the process of revising the Oxygen and Oxygen Equipment Local Coverage Determination (L33797) and the related Policy Article (A52514) to reflect the national CMS policy changes to NCD 240.2 and the removal of NCD 240.2.2 (see Appendix B and C of CMS Decision Memo).

Of note, coverage for hyperbaric and topical oxygen therapy in the Oxygen and Oxygen Equipment LCD (L33797) will remain unchanged.

As a reminder, on April 06, 2020, CMS issued an Interim final rule with comment period (CMS-1744-IFC), which suspended enforcement of the clinical indications for coverage for NCD 240.2 and LCD L33797.