MedicaidCoverageMedium impact
Oxygen Policy Clarification for Residents of Long Term Care Facilities
Illinois Medicaid - HFS·IL · Pulmonology, General Practice·Provider Notice
Effective date
Dec 1, 2012
We identified it
Jun 20, 2026
Summary
This policy clarifies oxygen billing requirements for long-term care facility residents, specifying that facilities must provide the first tank monthly without billing, while DME companies need prior approval. Only one stationary and one portable oxygen content code can be billed after the facility fulfills its supply requirement.
Action Required
Immediately: DME providers must obtain prior approval before dispensing oxygen to long-term care facility patients. Update billing system to prevent billing for first monthly tank (one H tank, two E tanks, or 20 pounds liquid oxygen) as this is facility responsibility. Ensure only one stationary and one portable content code are billed per resident when oxygen use exceeds two hours daily.