In 2017, CMS incorrectly applied a budget neutrality “offset” to 2017 rural fee schedules for oxygen concentrators. This led to an improper reduction in reimbursement for HCPCS E1390 by an additional 11 percent on average. This forced reimbursement rates in rural areas below the average regional competitive bidding special payment amounts (SPA).
Below is an article from Inside Health Policy on the oxygen reimbursement double-dip issue. The Council for Quality Respiratory Care (CQRC) suppliers and manufacturers is asking CMS to make changes to regulations on reimbursement, bid procedures and audits. The CQRC group and other DME providers throughout the country are hopeful HHS Secretary Tom Price can be helpful by setting rates during the second half of last year at levels paid during the first half of 2016.