National Coverage Analysis (NCA) Tracking Sheet

Home Use of Oxygen and Home Oxygen Use to Treat Cluster Headaches

CAG-00296R2

Issue

Currently, Medicare has a national coverage determination (NCD) for Home Use of Oxygen (NCD 240.2) that provides for coverage of oxygen in the home for Medicare beneficiaries under specific conditions. Additionally, Medicare has an NCD for Home Oxygen Use to Treat Cluster Headache (NCD 240.2.2) which provides coverage for the home use of oxygen for cluster headache through Coverage with Evidence Development (CED).

CMS received a formal request for a national coverage determination to reconsider coverage of the home use of oxygen for cluster headache. In addition to the formal request specific to the home use of oxygen for cluster headache, lessons learned from the COVID public health emergency have compelled us to review NCD 240.2 to ensure patient access to oxygen as needed both in the current environment and if necessary, in the future.

Therefore, CMS is opening this national coverage analysis (NCA) to determine if our current coverage of oxygen in the home, including home use of oxygen for cluster headaches, is reasonable and necessary under the Medicare program. CMS is soliciting public comment on this topic.

Benefit Category

Durable Medical Equipment

Requestor Information

Requestor Name Requestor Letter
The Alliance for Headache Disorders Advocacy View Letter
N/A

Important Dates

Formal Request Accepted and Review Initiated
08/17/2020
Expected NCA Completion Date
09/30/2021
Public Comment Period
08/17/2020 - 09/16/2020
Proposed Decision Memo Due Date
Proposed Decision Memo Released
07/02/2021
Proposed Decision Memo Public Comment Period
07/02/2021 - 08/01/2021
Decision Memo Released
09/27/2021
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
Heather Hostetler, J.D.
Heather.Hostetler@cms.hhs.gov
410-786-4515
Lead Medical Officers
Susan Miller, M.D.

Medicare Benefit Category Determination Date

Actions Taken

August 17, 2020

CMS initiates this national coverage analysis for Home Use of Oxygen and Home Oxygen Use to Treat Cluster Headaches. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review.

Instructions on submitting comments can be found at: https://www.cms.gov/Medicare/Coverage/InfoExchange/publiccomments.

To submit a comment, please use the orange "Comment" button at the top of the page. Enter comments directly into the "Submit A Public Comment" webpage.

July 2, 2021

September 27, 2021