Home Use of Oxygen

Oxygen is a colorless, odorless gas that comprises 21 percent of the atmospheric gases at sea level. Historically, long term supplemental oxygen has been administered in higher than atmospheric concentrations to patients with chronic hypoxemia, generally resulting from cardiac and/or pulmonary disease. The need for supplemental oxygen is assessed by direct or indirect measurement of the partial pressure of oxygen (conventionally expressed in millimeters of mercury, mm Hg) and the oxygen saturation of hemoglobin in arterial blood (expressed as a percent). Chronic oxygen therapy is generally administered via nasal cannulae, face mask, or tracheostomy, from a stationary or portable oxygen tank or an oxygen concentrator.

The medical literature documents health benefits as well as serious adverse events associated with supplemental oxygen use. In this light, it is clear that the decision to initiate, continue, or discontinue the use of supplemental oxygen should be guided by high quality scientific evidence.

Medicare has had a national policy on the home use of oxygen. The current version has been in effect since 10/27/1993. It allows for coverage of home oxygen for patients with oxygen partial pressure measurements at or below 55 mm Hg or oxygen saturation at or below 88%. If certain other diseases/conditions are present, an oxygen partial pressure of 56-60 mm Hg or an oxygen saturation of 89% are permitted. The Centers for Medicare and Medicaid Services (CMS) has internally generated a national coverage determination reconsideration to determine if there is sufficient evidence to change the current policy for beneficiaries having arterial oxygen partial pressure measurements in the range of 56-65 mmHg.

August 16, 2005

December 20, 2005

March 20, 2006