CommercialBilling CodesMedium impact
PAP209 - Oxygen and Oxygen Equipement - Unarchived policy - defined rental months, added rental codes, removed extra language
Blue Cross of Idaho·ID · Pulmonology, Internal Medicine, Family Medicine·Medical Policy
Effective date
Mar 1, 2026
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho has unarchived and revised their oxygen and oxygen equipment policy (PAP209), adopting Medicare Fee-For-Service payment rules for Commercial claims. The policy now includes detailed billing procedures, specific HCPCS codes, modifiers, and a 36-month rental cap consistent with CMS rules.
Action Required
By March 1, 2026: Billing team must update oxygen equipment billing procedures to follow Medicare FFS rules for Commercial claims. Implement 36-month rental cap for stationary oxygen equipment codes. Add required HCPCS modifiers (QA, QB, QE, QF, QG, QR) to billing system based on prescribed oxygen flow rates. Update billing software to include oxygen contents as part of equipment rental during the 36-month period and only bill separately after cap is reached. Reference Noridian LCD L33797 for detailed billing guidelines.