CMS DOES NOT LOOK AT FULL COST TO PROVIDE OXYGEN THERAPY
Medicare continues to not factor the true costs of oxygen therapy and the cost of the regulations that Medicare imposes on providers.
For a provider to deliver oxygen the cost are concentrator $575.00, oxygen tanks( avg 6 per week, but higher liter flows may use up to 20) $35.95 ea.,tank fills 3.95 ea tank, nasal cannulas 4 per month2 $1.00 ea, tubing 2 per month at $1.00 ea, connector $1.25 per month, delivery drivers time and paperwork for setup 1hr at 13.00 to 15.00 per hr, 15 pages of perwork for setup to meet criteria and regulations, gas,mileage and wear/tear on delivery van, cost of having someone on call 24/7 and overtime if called out after hrs or on weekend, cost of processing billing paperwork( we already have an order from physician but must have a CMN signed and returned with same info to bill Medicare), Billers time to submit and followup. Concentrator checks every six months, replace any equipment that has a problem, which is usually due to noncompliance on the patients side no matter how many times you reinstruct, taking out a washer for the regulator because they lost it when changing tanks, or tank keys to turn on the tanks, or delivering a tank to where ever they are at because they did not bring an extra tank. Then after 36 months reimbursed only for concentrator service at 2 units of 15.00 dollars at 80% because the patient cannot afford to pay their 20% share, once every six months. Also reimbursed for portable system at 80% of 72.00 per month, which at six tanks a week, plus supplies and delivery costs is about a 45% loss per month. We get the pleasure of after 60 months of breaking even or only losing 10%.Medicare does not reimburse for supplies and tanks during the first 36 months, which is the majority of the costs to provide service, so yes people are careful about where in the 36 month process they will accept a patient. Oh and I must not forget Medicare reimburses 60.00 bucks a month for 36 months for a portable oxygen concentrator this equals 2,160.00 dollars. The cheapest poc on the market costs 2600.00 dollars to the dealer, and this does not include shipping and cost of record keeping because we must be able to trace every piece of equipment we put out.