Home oxygen therapy is covered by Medicare only when it meets both statutory and medical necessity criteria. This includes a physician's determination of severe lung disease or hypoxia-related symptoms, qualifying blood gas studies under specific conditions, and evidence that alternative treatments have been ineffective, with detailed requirements for Group I and II coverage based on specific blood gas levels and associated health conditions.
Coverage for sleep therapy devices, including C-PAP and bi-level devices, is contingent upon meeting Medicare's specific criteria, which include clinical evaluations, sleep test results, and proper usage training. Initial coverage is provided based on the Apnea-Hypopnea Index (AHI) or Respiratory Disturbance Index (RDI) values, along with additional health considerations; further details on sleep tests and qualifications for device coverage can be obtained from our store or your physician.
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