Oxygen Billing Services
Home oxygen patients can stay on service for years, and every stage has its own rules. We keep your oxygen claims accurate from qualifying test to contents billing after the cap.
- Qualifying test and order review
- 36-month rental month tracking
- Contents billing after the cap
- Denial follow-up and appeals
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HIPAA compliant. We never share your data.
Why suppliers hand us their oxygen billing
- 99.9% accuracy on the claims we work
- 97% collection rate
- We work inside Brightree, Bonafide, NikoHealth or TIMS
- HIPAA compliant handling of patient data
- ISO 9001 and ISO 27001 certified
- Each payer’s oxygen rules kept in your billing setup
Qualifying the patient
Medicare coverage depends on the treating practitioner documenting a condition oxygen is expected to improve, backed by a qualifying blood gas or oximetry test. Group I generally means an arterial PO2 at or below 55 mm Hg or a saturation at or below 88%, at rest, during exercise or during sleep. Group II covers a PO2 of 56 to 59 mm Hg or a saturation of 89%, plus dependent edema suggesting heart failure, pulmonary hypertension or cor pulmonale, or erythrocythemia.
The test has to be done by a qualified provider, never by the DME supplier. An exercise qualification needs three tests in the same session: at rest without oxygen, exercising without oxygen, and exercising with oxygen to show improvement. Our intake team checks the test type, values and timing before anything is delivered.
Orders without the CMN
For dates of service on or after January 1, 2023, the oxygen Certificate of Medical Necessity (CMS-484) is gone. Claims sent with one are rejected.
The order and the medical record now carry that weight, so flow rate, frequency of use and portable equipment all need to match between the order, the delivery and the claim. We compare all three before billing.
Billing systems we work in
We track month counts, equipment history and lifetime dates in the system you already use.
How we run your oxygen billing
Before the claim
- Test and order review: we confirm the qualifying test and order support what you deliver and bill.
- Rental month tracking: Medicare pays for oxygen equipment as a monthly rental for up to 36 months. Breaks in need, a move, a hospital stay or a change of supplier can all affect the count, so we keep each patient’s months in line with Medicare’s records.
- Payer setup: Medicare Advantage and commercial plans often set their own rules, including prior authorization, purchase instead of rental, or recertification. We track authorizations so service never runs on an expired approval.
After the claim
- Post-cap billing: we make sure contents billing after month 36 is captured, not missed.
- Lifetime tracking: we watch the five-year reasonable useful lifetime so new equipment and a new rental period start on schedule.
- Denial follow-up: we work denials by cause, appeal when the record supports it, and fix patterns at intake.
The 36-month rental period and after
After month 36, the supplier keeps ownership but must keep furnishing and servicing the equipment for the rest of its five-year reasonable useful lifetime, as long as the patient needs it. If your month count drifts from Medicare’s records, the result is denials now or overpayment findings later.
| Situation after month 36 | What can be billed |
|---|---|
| Gaseous or liquid system | Oxygen contents can still be billed |
| Concentrator without separate contents | Usually no further monthly payment |
| Five-year lifetime ends | Patient can elect new equipment, starting a new rental period |
Related respiratory equipment follows different rules. Nebulizers have their own coverage policy tied to the drug and diagnosis. Home ventilators are paid as frequent and substantial servicing items, not capped rentals.
Oxygen is billed as a rental, so documentation has to hold up month after month. See our rental billing compliance case study.
What keeps your oxygen claims clean
Certified processes
ISO 9001 quality management and ISO 27001 information security, audited by outside bodies.
Order, delivery and claim matched
Flow rate, frequency and portable equipment line up before a claim goes out.
Lessons fed back
Every denial we work gets traced to its cause and fixed at intake.
Your patient data stays protected
We handle patient records under HIPAA and an ISO 27001 certified information security program. We work in your own billing system, so your data stays where it already lives.
When an oxygen claim is denied
Oxygen denials often trace back to a mismatched order, a qualifying test that doesn’t meet the rules, or a month count that drifted. We work the denial, appeal when the record supports it, and correct the step that caused it.
What changes when we take over
- Month counts you can trust. Rental months and lifetime dates stay in line with Medicare’s records.
- Post-cap revenue captured. Contents billing after month 36 doesn’t slip through.
- One team for all your equipment. Oxygen sits alongside the rest of your DME billing services.
Have older oxygen claims stuck in A/R? Here is how we handled aging DME claims.
Related Reading
Guides and results for DME suppliers
DME Capped Rental Billing: How to Track the 13 Months
Avoid lost rental payments with a clean month-by-month tracking process.
Read more →GuideHow to Choose a DME Billing Partner
What to check beyond price before you hand over your claims.
Read more →Case StudiesDME Billing Case Studies
See how we’ve fixed denials, delays and underpayments for DME suppliers.
Read more →Frequently asked questions
Do oxygen claims still need a CMN?
No. For dates of service on or after January 1, 2023, Medicare retired the oxygen CMN, and claims submitted with one are rejected. The order and medical record support the claim instead.
How long does Medicare rent oxygen equipment?
Up to 36 months. The supplier then keeps furnishing the equipment for the rest of its five-year reasonable useful lifetime while the patient still needs it.
Can we bill anything after month 36?
Yes, for patients on gaseous or liquid systems, oxygen contents can still be billed. Concentrator patients usually do not generate monthly payment after the cap.
Can a DME supplier perform the qualifying oxygen test?
No. The qualifying test has to be done by a qualified provider, not the supplier furnishing the oxygen.