National Coverage Determination (NCD)

Home Oxygen Use to Treat Cluster Headache (CH)

240.2.2

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Tracking Information

Publication Number
100-3
Manual Section Number
240.2.2
Manual Section Title
Home Oxygen Use to Treat Cluster Headache (CH)
Version Number
2
Effective Date of this Version
09/27/2021
Implementation Date
01/03/2023

Description Information

Benefit Category
Durable Medical Equipment


Please Note: This may not be an exhaustive list of all applicable Medicare benefit categories for this item or service.

Item/Service Description

Effective September 27, 2021, the Centers for Medicare & Medicaid Services removed the national coverage determination (NCD) for home oxygen use to treat cluster headaches. In the absence of an NCD, coverage determinations will be made by the Medicare Administrative Contractors under section 1862(a)(1)(A) of the Social Security Act, as allowed and described in Chapter 1, Section 240.2 (Home Use of Oxygen), Subsection D, of Publication 100-03 of the NCD Manual.

Indications and Limitations of Coverage

Transmittal Information

Transmittal Number
11263
Revision History

01/2011 - After careful reconsideration, effective for claims with dates of service on and after January 4, 2011, Medicare will allow for coverage of home use of oxygen to treat Medicare beneficiaries diagnosed with CH when beneficiaries are enrolled in clinical studies that are approved by CMS for the purpose of gaining further evidence. Effective date: 01/04/2011. Implementation date: 02/15/2011. (TN130) (CR7235)

02/2022 - The purpose of the Change Request is to revise Section 240.2 and Section 240.2.2 of the National Coverage Determination (NCD) Manual (Pub. 100-03), Chapter 1, Part 4, and to inform the Medicare Administrative Contractors (MAC)s of the changes associated with these NCDs effective September 27, 2021. The Centers for Medicare & Medicaid Services finalized revisions to two separate, but medically related, NCDs for oxygen therapy and oxygen equipment in the home. Effective date: 09/27/2021 Implementation date: 06/14/2022. (TN 11263) (CR12607)

05/2022 - Transmittal 11263, dated February 10, 2022, are being rescinded and replaced by Transmittal 11429, dated, May 23, 2022 to extend the implementation date to January 3, 2023. All other information remains the same. (TN 11429) (CR12607)

National Coverage Analyses (NCAs)

This NCD has been or is currently being reviewed under the National Coverage Determination process. The following are existing associations with NCAs, from the National Coverage Analyses database.

Additional Information

Other Versions
Title Version Effective Between
Home Oxygen Use to Treat Cluster Headache (CH) 2 09/27/2021 - N/A You are here
Home Oxygen Use to Treat Cluster Headache (CH) 1 01/04/2011 - 09/27/2021 View