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Military Health System

TRICARE Reimbursement Manual 6010.61-M, April 1, 2015
General
Chapter 1
Section 12
Oxygen And Related Supplies
Issue Date:  August 26, 1985
Authority:  32 CFR 199.4(d)(3)(iv)
Revision:  
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.
2.0  ISSUE
How are oxygen and supplies related to the use of oxygen to be reimbursed?
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.
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