1.0 APPLICABILITY
This policy is mandatory for
reimbursement of services provided by either network or non-network
providers. However, alternative network reimbursement methodologies
are permitted when approved by the Defense Health Agency (DHA) and
specifically included in the network provider agreement.
3.0 POLICY
3.1 Payments
may be made for oxygen and for the rental or purchase of the oxygen
concentrator. (Refer to
Section 11 for
Durable Medical Equipment (DME)).
3.2 When the
oxygen concentrator is rented or purchased cost-sharing shall be
determined by using the allowable charge methodology.
3.3 When oxygen concentrators are
cost-shared on a rental basis, the DME cost-sharing policy will
not apply even though the purchase price for this equipment has
been reached.