Understanding CMS's New COPD Coverage: What HME Providers Need to Know

Published in Member Communities on July 02, 2025

Ronda BuhrmesterBy Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, VGM & Associates

On June 9, 2025, CMS released the implications of the newly finalized National Coverage Determination (NCD) for home mechanical ventilation (HMV) and respiratory assist devices (RAD). While the final NCD has an effective date of June 9, 2025, implementation instructions are yet to come!

The final NCD introduces expanded coverage for RADs and HMVs for patients with chronic respiratory failure due to COPD.

Key changes include: 

  • Clearer Initial and Continuing Coverage Criteria: CMS now outlines specific PaCO₂ with an arterial blood gas (ABG) and continued usage metrics for both RADs and HMVs. 
  • Compliance Demands: New documentation, usage tracking, and patient re-evaluation requirements will increase operational oversight—without added reimbursement. 
  • Hospital Discharge Provisions: Immediate post-discharge coverage is available for patients meeting defined clinical criteria. 
  • Grandfathering: Existing patients on HMV and RADs for COPD are grandfathered in.  
  • MAC Discretion: For cases outside the NCD scope, the DME Medicare Administrative Contractors (DME MACs) retain authority to determine coverage. 

Emphasis needs to be on the importance of proactive education and compliance monitoring with referral sources, staff, and patients. Suppliers are encouraged to prepare for increased documentation demands, patient re-evaluations, and tighter monitoring—without additional reimbursement. 

As the industry awaits further CMS instructions, one message was clear: educate, adapt, and stay ahead. 

We recently held a webinar with myself and industry experts Kim Cuce’, Noel Neil, and Zach Gantt about the key changes of this decision, the operational and financial impact on DME suppliers, and actionable strategies to navigate the new landscape. Click here to view the recording

For any questions, please reach out to me at ronda.buhrmester@vgm.com


TAGS

  1. billing & reimbursement
  2. cms
  3. oxygen
  4. reimbursement
  5. respiratory

From Our Experts

2026 O&P Woman of the Year Nominations Open thumbnail 2026 O&P Woman of the Year Nominations Open Nominate a leader in orthotics and prosthetics for the 2026 O&P Woman of the Year Award. Recognize impact in patient care, innovation, and industry leadership. Meet Lisa Wells: 2026 HME Woman of the Year Winner thumbnail Meet Lisa Wells: 2026 HME Woman of the Year Winner Lisa Wells, Senior Vice President at Med-South, Inc., has been named the 2026 HME Woman of the Year for her leadership in HME, compliance, and industry advocacy. VGM Appoints Billing and Reimbursement Leader thumbnail VGM Appoints Billing and Reimbursement Leader VGM & Associates names Stephanie Robinson Director of Billing and Reimbursement, strengthening support for HME providers navigating RCM, compliance, and payer challenges. VGM Collaborates with Resmed to Expand Sleep Therapy Support for HME Providers thumbnail VGM Collaborates with Resmed to Expand Sleep Therapy Support for HME Providers Collaboration brings together innovative, connected sleep health tools, home-based diagnostic support, and adherence resources to help providers streamline care and improve patient access. U.S. Rehab, Permobil Renew Partnership and Expand CRT Access thumbnail U.S. Rehab, Permobil Renew Partnership and Expand CRT Access U.S. Rehab and Permobil renew partnership, expanding CRT solutions, product access, and clinical outcomes for providers and mobility users. You Are the Reason This Works thumbnail You Are the Reason This Works In home medical equipment and non-acute care, most of what makes things work is not visible. But they are the reason care happens the way it should. Meet Julie Osborn: 2026 HME Woman of the Year Finalist thumbnail Meet Julie Osborn: 2026 HME Woman of the Year Finalist Meet Julie Osborn, 2026 HME Woman of the Year nominee and recognized leader in the HME and complex rehab technology (CRT) industry, known for driving growth, expanding access, and advancing patient-centered care. Meet Jeaneen Cole: 2026 HME Woman of the Year Finalist thumbnail Meet Jeaneen Cole: 2026 HME Woman of the Year Finalist Meet Jeaneen Cole, VP of Quality and Compliance at DASCO HME and a 2026 HME Woman of the Year finalist, recognized for leadership in healthcare compliance, operational excellence, and patient-centered care.