VGM & ASSOCIATESHealthcare MSO
Full Menu Search

Upcoming Educational Opportunities About Oxygen Policy Changes

Published in Government Relations on June 06, 2022

Have you been able to keep up with the oxygen policy updates? If the answer is no, we understand why! It’s due to all the confusion with the policy changes on top of dealing with the PHE. The latest announcement is that CMS is delaying the implementation date to January 3, 2023. Yes, that is correct. The implementation date has changed to January 2023 to be in alignment with the elimination of the CMN. Click here to read more.

Even though the initial implementation date has changed from June 2022 to January 2023 now, Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, will move forward with offering education to the industry. Here are some opportunities to learn about the oxygen policy changes:

Click the links above to learn more and register.

In addition, on Friday, June 3, 2022, the DME MACs made a revision to the CMS-1744-IFC regarding the CMN/DIF instructions during the PHE:

CMN and DIF Instructions - Oxygen (Form CMS 484.3) and External Infusion Pumps (Form 10125)
CMS-1744-IFC stated that CMS would exercise enforcement discretion for clinical indications of coverage for the oxygen NCDs and LCDs during the PHE. Numerous fields on the Certificate of Medical Necessity (CMN) for oxygen are directly related to the clinical indications. After carefully reviewing the CMN and the related claims processing issues that would result from having missing information or having clinical information for which the form was intended, CMS has determined that requirements for a CMN for oxygen claims will not be enforced during the COVID-19 PHE. The same concerns that apply to the oxygen CMN also apply to the External Infusion Pump (EIPs) DIF; therefore, the requirements for a DIF for EIP claims will also not be enforced. Suppliers should follow the guidance in the Claim Instruction section above for oxygen and EIP claims.

There is no requirement to submit a CMN or DIF during the PHE for oxygen or EIPs. If CMNs or DIFs are not submitted, suppliers must use the CR modifier and COVID-19 narrative for any oxygen or EIP claims submitted during the COVID PHE. CMNs or DIFs are not required regardless of the diagnosis or etiology necessitating the use of the CMN-related or DIF-related DME. Use of the CR modifier and COVID-19 narrative simply reflects that the claim was submitted during the COVID PHE.

Click here to learn more.

TAGS

  1. billing & reimbursement
  2. education
  3. hme
  4. vgm
  5. vgm government

Get Connected

Stay up-to-date on the latest resources and news provided by VGM & Associates.

Sign Up for Email

From Our Experts

Introducing Patient Voices: Access to HME Matters thumbnail Introducing Patient Voices: Access to HME Matters The VGM Government Relations team is excited to announce Patient Voices: Access to HME Matters, a new way for patients, providers, vendors, caregivers, and industry partners to share their experiences with home medical equipment. Every story matters. AAHomecare Survey Results of RID Program thumbnail AAHomecare Survey Results of RID Program Thank you to AAHomecare for initiating this important survey demonstrating the significant risks to the DMEPOS industry should Remote Item Delivery Competitive Bid Program (RID CBP) Round 2028 move forward as is. VGM Group is proud to support the survey efforts to maximize provider participation. See below for the survey summary and analysis. Competitive Bidding Update: NPEast and NPWest Updating Licensure Requirement Information for Competitive Bidding Product Categories thumbnail Competitive Bidding Update: NPEast and NPWest Updating Licensure Requirement Information for Competitive Bidding Product Categories Per the Remote Item Delivery Competitive Bidding Program (RID CBP) Round 2028 requirements, bidders must meet all business and product category licensure requirements across every state, the District of Columbia, and the U.S. territories to be eligible to be a contract winner. New CMS Nationwide Probationary Prior Authorization Requirement for Newly Enrolled Suppliers of Certain DMEPOS Items thumbnail New CMS Nationwide Probationary Prior Authorization Requirement for Newly Enrolled Suppliers of Certain DMEPOS Items On Sept. 2, 2026, CMS introduced the Probationary Prior Authorization (PPA) program that will place newly enrolled DMEPOS Suppliers and those undergoing 100% change in ownership on a one-year probationary period. Effective Oct. 15, impacted suppliers will be required to submit a prior authorization request for specific HCPCS codes. OIG Report Signals Increased Fraud Oversight for DMEPOS Suppliers thumbnail OIG Report Signals Increased Fraud Oversight for DMEPOS Suppliers The HHS Office of Inspector General (OIG) recently released a white paper examining ongoing Medicare fraud involving durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS). Preparing for Increased Audit Activity: How VGM Group and The van Halem Group Can Help thumbnail Preparing for Increased Audit Activity: How VGM Group and The van Halem Group Can Help The recent HHS Office of Inspector General (OIG) report on DMEPOS fraud signals that CMS is likely to increase oversight activities across the industry. The report calls for enhanced supplier enrollment screening, more aggressive medical reviews, expanded use of artificial intelligence and data analytics, greater physician order verification, and increased scrutiny of supplier ownership and billing practices. CMS Releases Critical Updates On The Medicare Supplier Enrollment Moratorium And Round 2028 Competitive Bidding Program thumbnail CMS Releases Critical Updates On The Medicare Supplier Enrollment Moratorium And Round 2028 Competitive Bidding Program See CMS' notice on the Medicare Supplier Enrollment Moratorium below: Medicare's DMEPOS Supplier Enrollment Moratorium Has Expired | Action Required for Round 2028 Bidders This message is to inform you that the 6-month temporary moratorium on accepting Medicare supplier enrollment applications, which became effective on February 27, 2026, has now expired as of August 27, 2026. CMS Updates CBIC Website Bid Preparation Guidance for Round 2028 Competitive Bidding Program thumbnail CMS Updates CBIC Website Bid Preparation Guidance for Round 2028 Competitive Bidding Program On August 13, 2026, CMS posted several updated and new Fact Sheets and one new FAQ to the Bid Preparation Phase page on the CBIC website. Providers interested in submitting a bid for Round 2028 can find more program details, including the estimated number of contract awards, for each category.

Together We Will Make Sure You Get Paid

LEARN MORE ABOUT HOW WE CAN HELP