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US · guidance

CMS Pub. 100-04, ch. 20, § 100.2.3.3

A/B MAC (HHH) or DME MAC Review of Oxygen

activein force · 2026-08-25 – presentas-observed

Certifications

(Rev. 1, 10-01-03)

All claims with initial certifications calling for oxygen flow rates of more than 4 liters per

minute must be reviewed before payment is authorized.

Items Requiring Special Attention –

a. Oxygen Delivery or Supply Prescribed - If the treating physician has specified the

oxygen equipment to be supplied, A/B MACs (A) and (HHH) and DME MACs

ensure that the equipment furnished is consistent with that prescribed.

b. Treating Physician Identification - A/B MACs (A) and (HHH) and DME MACs

must ensure that the CMN or Form CMS-484 has been signed by the treating

physician. A stamped signature is unacceptable. The physician's identification

number must be the Unique Physician Identification Number (UPIN).

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
d3329eb048edab127bf31c401b768268568374e19811b363c554a1fec755cb32
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