National Coverage Determination (NCD)

Home Oxygen Use to Treat Cluster Headache (CH) - RETIRED


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Tracking Information

Publication Number
Manual Section Number
Manual Section Title
Home Oxygen Use to Treat Cluster Headache (CH) - RETIRED
Version Number
Effective Date of this Version
Implementation Date

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.

Indications and Limitations of Coverage

240.2.2 - Home Oxygen Use to Treat Cluster Headache (CH) (RETIRED)
(Rev. 11892; Issued: 03-09-23; Effective: 04-10-23; Implementation: 04-10-23)

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.

Transmittal Information

Transmittal Number
Revision History

05/2022 - Transmittal 11263, dated February 10, 2022, are being rescinded and replaced by Transmittal 11429, dated, May 23, 2022 to extend the implementation date to January 3, 2023.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)

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)

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)

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) - RETIRED 3 04/10/2023 - N/A You are here
Home Oxygen Use to Treat Cluster Headache (CH) 2 09/27/2021 - 04/10/2023 View
Home Oxygen Use to Treat Cluster Headache (CH) 1 01/04/2011 - 09/27/2021 View