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Contractor Information

Contractor Name: Palmetto GBA - Full list of policies of this Medicare Contractor Contractor Number: 11502 Contractor Type: MAC B

LCD Information

LCD ID Number: L37873 Status: A-Approved LCD Title: Topical Oxygen Therapy Geographic Jurisdiction: North Carolina Other Jurisdictions Original Determination Effective Date: 05/06/2019 Original Determination Ending Date: Revision Effective Date: 05/04/2023 Revision End Date: CMS National Coverage Policy: Title XVIII of the Social Security Act, §1862(a)(1)(A) allows coverage and payment for only those services that are considered to be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member. Title XVIII of the Social Security Act, §1862(a)(1)(D) no payment may be made for any expenses incurred for items or services in the case of clinical care items and services provided with respect to research and experimentation. 42 CFR §410.26(a)(2) defines direct supervision. 42 CFR §410.74(b) and (c) Physician assistants' services 42 CFR §410.75(c)(1) Nurse practitioners' services 42 CFR §410.76(b)(1) Clinical nurse specialists' services CMS Internet-Only Manual, Pub. 100-02, Medicare Benefit Policy Manual, Chapter 6, §20.5.2 Coverage of Outpatient Therapeutic Services Incident to a Physician's Service Furnished on January 1, 2010 through December 31, 2019 CMS Internet-Only Manual, Pub. 100-03, Medicare National Coverage Determinations (NCD) Manual, Chapter 1, Part 1, §20.29 Hyperbaric Oxygen Treatment Sorry, you need to login or register to view additional sections of this Medicare policy. *