Modifier N3

The Centers for Medicare and Medicaid Services (CMS) published a Medicare Learning Network article announcing the new N-modifiers for oxygen. The 3 new modifiers for home oxygen use under national coverage determination (NCD) 240.2 and the DME MAC Oxygen and Oxygen Equipment Local Coverage Determination (LCD) and LCD-related Policy Article (PA) were created to indicate the appropriate treatment regimen and presence of supporting documentation for each Medicare patient oxygen therapy group:

The new modifiers are effective January 1, 2023 and will be available in the April 2023 HCPCS code release.

D. Other

The MAC may determine reasonable and necessary coverage of oxygen therapy and oxygen equipment in the home for patients who are not described in subsection B or precluded by subsection C of this NCD. Initial coverage for patients with other conditions may be limited to the shorter of 90 days or the number of days included in the practitioner prescription at MAC discretion. Oxygen coverage may be renewed if deemed medically necessary by the MAC.

MACs may also allow beneficiaries who are mobile in the home and would benefit from the use of a portable oxygen system in the home to qualify for coverage of a portable oxygen system either (1) by itself, or, (2) to use in addition to a stationary oxygen system.

(This NCD was last reviewed July 2022.)

(See §280.1 and the Medicare Benefit Policy Manual, Chapter 15, "Covered Medical and Other Health Services," §110.)


Last Updated Jan 16 , 2023