Home Oxygen: 3 New Claims Modifiers and Home Health Prospective Payment System: CY 2023 Rural Add-on Policy 

Mary Madison, RN, RAC-CT, CDP  
Clinical Consultant – Briggs Healthcare

CMS added 3 new modifiers for home oxygen use under national coverage determination (NCD) 240.2 to indicate the appropriate treatment regimen and presence of supporting documentation for each Medicare patient group:

  • Section B, Group I: modifier N1
  • Section B, Group II: modifier N2
  • Section D: modifier N3

Patients under NCD Section B, Group II and Section D have payment and recertification requirements that don’t apply to Group I. The new modifiers are effective January 1, 2023 and will be available in the April 2023 HCPCS code release.

Your Medicare Administrative Contractor will provide more details.

Section 4137 of the Consolidated Appropriations Act, 2023 extends the 1% rural add-on payment for home health periods and visits that end in CY 2023 for counties classified as ‘‘low population density.’’ CMS will increase the 30-day base payment rates by the 1% rural add-on before applying any case-mix and wage index adjustments. There are no changes to the fixed-dollar loss ratio, budget neutrality factors, or final base payment rates.