Home oxygen billing software has to follow rules most DME items do not. Medicare pays at most 36 monthly rentals for oxygen equipment, yet the supplier must keep providing equipment, contents, and repairs through the 5-year reasonable useful lifetime. Payments shift with flow rate, and the oxygen CMN is gone. Ask vendors to show each rule live.
The Oxygen Rules Home Oxygen Billing Software Must Track
All of the payment rules below come from the Medicare Oxygen and Oxygen Equipment Policy Article, A52514.
Medicare oxygen rule | What the software must do |
Equipment payment stops after 36 monthly rentals | Count paid months per patient and stop billing equipment at 36 |
The supplier billing month 36 must keep supplying equipment, accessories, contents, maintenance, and repair through month 60 | Keep the patient active for service with no equipment billing |
A new 36-month period starts only after damage beyond repair, theft, or loss | Never reset the count for a supplier change, upgrade, or break in service |
The 5-year useful lifetime runs from the initial date of service | Track the start date, not the age of the equipment |
Stationary payment rises above 4 LPM and falls below 1 LPM | Store the ordered flow rate and apply the adjustment |
Portable equipment started later can keep billing until its own 36 payments | Track stationary and portable separately |
The Oxygen CMN Is Gone, but Documentation Is Not
CMS eliminated the oxygen CMN (CMS-484) for claims with dates of service on or after January 1, 2023. Claims that still include one are rejected and returned (CGS on CMN and DIF elimination). The standard written order, proof of delivery, and medical records still apply. They matter: CMS reports an 11.3% improper payment rate for oxygen in 2024, with insufficient documentation behind 59.3% of those improper payments (CMS oxygen compliance tips).
Beyond Oxygen
Respiratory suppliers often bill CPAP, BiPAP, and ventilators too, each under different rules. See our CRT and ventilator billing FAQ, the PHE oxygen requalification rules, and this guide to managing equipment rentals. Software applies the rules. Your team still confirms each patient’s qualifying documentation.
Where NikoHealth Fits
NikoHealth billing software automates recurring rental invoicing, applies capped rental and payer frequency rules, and tracks maintenance on rental assets. In-Home Respiratory, a CPAP, BiPAP, and home ventilation supplier, reports “a 20 percent improvement in collections speed” (case study).
