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CMS Pub. 100-04, ch. 20, § 130.6.1

Oxygen Equipment and Contents Billing Chart

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

The following chart indicates what oxygen fee schedule component is billable/payable

under various transaction scenarios for providers and suppliers:

1. Situation: Beneficiary Uses a Stationary System Only

a. Rental Cases (Beneficiary Uses a Stationary System Only)

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Concentrator Yes No No No

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

E1377

E1378

E1379

E1380

E1381

E1382

E1383

E1384

E1385

E1400

E1401

E1402

E1403

E1404

E1405

E1406

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Gaseous Yes No No No

E0424

Liquid Yes No No No

E0439

b. Purchase Cases (Beneficiary Uses a Stationary System Only)

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Concentrator No No No No

Gaseous No Yes No No

E0441

Liquid No Yes No No

E0442

2. Situation: Beneficiary Uses Both a Stationary and Portable System

a. Rents Stationary/Rents Portable

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Concentrator Yes No Yes No

E1377

E1378

E1379

E1380

E1381

E1382

E1383

E1384

E1385

E1400

E1401

E1402

E1403

E1404

E1405

E1406

E0431

E0434

Gaseous Yes No Yes No

E0424 E0431

Liquid Yes No Yes No

E0439 E0434

b. Rents Stationary/Owns Portable

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Concentrator Yes No No No

E1377

E1378

E1379

E1380

E1381

E1382

E1383

E1384

E1385

E1400

E1401

E1402

E1403

E1404

E1405

E1406

Gaseous Yes No No No

E0424

Liquid Yes No No No

E0439

c. Owns Stationary/Owns Portable

Type of System

Stationary

Monthly

Payment

Oxygen

Content Fee

Portable Add-On

Portable

Contents Fee

Concentrator No No No Yes

E0443

E0444

Gaseous No Yes No No

E0441

Liquid No Yes No No

E0442

d. Owns Stationary/Rents Portable

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable Add-On

Portable

Contents Fee

Concentrator No No Yes Yes

E0431

E0434

E0443

E0444

Gaseous No Yes Yes No

E0441 E0431

Liquid No Yes Yes No

E0442 E0434

3. Situation: Beneficiary Uses a Portable System Only

a. Rents Portable System (Beneficiary Uses a Portable System Only)

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Gaseous No No Yes Yes

E0431 E0443

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Liquid No No Yes Yes

E0434 E0444

b. Owns Portable System (Beneficiary Uses a Portable System Only)

Type of System Stationary

Monthly

Payment

Oxygen

Content Fee

Portable

Add-On

Portable

Contents Fee

Gaseous No No No Yes

E0443

Liquid No No No Yes

E0444

NOTE: For HHAs revenue codes 0601, 0602, 0603, and 0604 may apply when billing

for oxygen under the situations in this chart.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
d2096c95d2144fe230fd5d00b3c137d99ee636c9c4aac1d70d4e8609802af2ad
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