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In a memo just released by the Centers for Medicare & Medicaid Services (CMS), it was announced that upcoming changes were coming to two separate, but medically related, National Coverage Determinations (NCDs). Changes include removing the NCD for Home Oxygen Use to Treat Cluster Headache (CH) (240.2.2) and revising the NCD for Home Use of Oxygen (240.2). CMS will allow the Medicare Administrative Contractors (MACs) to make coverage determinations regarding the use of home oxygen and oxygen equipment for cluster headaches. Below are the NCD revisions.

Changes to NCD 240.2 Home Use of Oxygen are as follows:

  • The treatment of patients with both acute and chronic conditions who require the medical gas on either a short- or long-term basis.
  • Patients whose initial oxygen prescription does not originate during an inpatient hospital stay, the time of need is during the period when the treating practitioner notes signs and symptoms of illness that can be relieved by oxygen in the patient who is to be treated at home.
  • Initial coverage for patients with other conditions may be limited to the shorter of 120 days or the number of days included in the practitioner prescription. Oxygen coverage maybe renewed if medically necessary.
  • The term “renewed” now appears in the NCD and has replaced the term “recertification.”


Additional recommendations during the comment period included but are not limited to:

  • Remove the Certificate of Medical Necessity (CMN) requirement for home oxygen and instead use Standard Written Orders/Clinical Data Element Templates;
  • Minimize the requirement for patients to try other alternative treatments prior to being prescribed oxygen; and
  • Remove the term “chronic stable state”; and change recertification and testing requirements.


The van Halem Group will keep you posted on the developing changes.