CMS Publishes New Oxygen Fee Schedule

Starting April 1, the new rates don’t apply budget neutrality, resulting in an increase in reimbursement for oxygen products nationwide.

CMS has published its April 2021 DMEPOS fee schedule, which includes new oxygen rates that do not apply budget neutrality.

The change results in 5 percent to 11 percent increases in oxygen products across the country, according to the American Association for Homecare. The rates are effective April 1.

Congress introduced Budget neutrality as part of the Deficit Reduction Act, and CMS applied it in 2006 by lowering reimbursement for stationary oxygen equipment to offset the increased use of oxygen-generating portable equipment (OPGE). In 2019, CMS expanded that application to the entire oxygen product category.

“Budget neutrality applies an additional reimbursement cut to oxygen products that already underwent a cut from competitive bidding,” a statement from AAHomecare read. “This fix on oxygen payment policy comes after five years of persistent advocacy to Congressional offices and CMS.”

Some changes in the April rates from the adjusted January 2021 rates:

  • CBAs – 10 percent increase on average, ranging from 8 percent to 11 percent.
  • Non-Rural Areas – 5.1 percent increase on average, ranging from 4.9 percent to 5.4 percent.
  • Rural Areas – 4.9 percent increase on average, ranging from 4.7 percent to 5.2 percent

For more information, providers can access CMS’s official fee schedule, and AAHomecare has provided an Excel file of its fee schedule analysis and comparison, as well.

 

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