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.