Current through Register 1531, September 27, 2024
(A) Payment to a provider for the purchase of
oxygen and respiratory therapy equipment shall be the lowest of:
(1) the provider's usual and customary charge
to the general public;
(2) the
adjusted acquisition cost of the item plus a markup not to exceed:
(a) 50% for any item whose adjusted
acquisition cost is less than $25;
(b) 45% for any item whose adjusted
acquisition cost is $25 or greater and less than $100;
(c) 40% for any itemwhose adjusted
acquisition cost is $100 or greater and less than $200;
(d) 35% for any item whose adjusted
acquisition cost is $200 or greater and less than $300; or
(e) 30% for any item whose adjusted
acquisition cost is $300 or greater; and
(3) the fee set forth in the applicable fee
schedule of the Division of Health Care Finance and Policy.
(B) When oxygen is provided in
partially full tanks, the rate of payment shall be prorated by multiplying the
maximum allowable fee by the percentage of the complete tank
consumed.
(C) Payment for the
following is included in the fee for the purchase of gaseous and liquid oxygen
calculated in accordance with 130 CMR 427.423(A):
(1) delivery of gaseous or liquid oxygen,
including the cost of 24-hour service;
(2) instruction of the recipient and
caregiver, if any, in the safe and proper use of oxygen; and
(3) accessories required for the initial
setup.
(D) Payment for
the following is included in the fee for the purchase of oxygen and respiratory
therapy equipment calculated in accordance with 130 CMR 427.423(A):
(1) delivery to and installation at the site
where the equipment will be used;
(2) instruction of the recipient and
caregiver, if any, in the proper operation of the equipment; and
(3) accessories required for the initial
setup.
(E) Purchased
oxygen and respiratory therapy equipment must be:
(1) clean and sterilized when
appropriate;
(2) in proper working
condition; and
(3) new at the time
of purchase, except for equipment purchased pursuant to
130
CMR 427.425.
