A physician must write a prescription for oxygen therapy prior to delivery. The prescription will indicate the flow rate, how much oxygen you need per minute -- referred to as liters per minute (LPM) -- and when you need to use oxygen. Also necessary is Diagnosis, portability (if needed), and length of need. Some people use oxygen therapy only while sleeping, others only while exercising, and still others need oxygen continuously. Your physician will order a blood test or oximetery test that will indicate what your oxygen level is and help determine what your needs are. A written prescription is required prior to delivery.
Medicare, Medicaid, and Commercial Insurance
Certain insurance polices may pay for all your oxygen, but payment is based on laboratory results, diagnosis, and other information. The information listed below will help you to determine insurance coverage.
Medicare – In addition to a prescription, Medicare requires a Certificate of Medical Necessity (CMN) to be filled out by your physician. CMN Oxygen requirements are as follows
- Length of need
- Diagnosis, a respiratory ailment showing the need for oxygen
- Oxygen Blood Gas to be 56-59 or below, or Oxygen Saturation level to be 89 or below
- How the test was taken, room air, during exercise, or while sleeping
- The testing facility where blood gasses or oximetery was performed
- Portability if needed
- Liter flow prescribed
- Physicians Signature
Third Party Insurances – All third party insurances require a prescription as described above. Requirements for oxygen are different for each insurance plan. We will contact your insurance company for you and request benefit coverage, and obtain prior authorization if needed.