It was great speaking with you on the phone and I appreciate you taking the time to educate us about the “door-to-door” charging ability of hyperbaric treatments. If you could send me any resources you have, or point me in the right direction regarding where to look in our HBO reference, it would be much appreciated! Even a brief summary of what we discussed over the phone via email about the air breaks and ascent and descent being a part of the time we are able to charge for would be helpful to back us u
CMS published Transmittal 3280, Effective January 1, 2015, HCPCS code C1300, Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval has been discontinued. Hospitals providing hyperbaric oxygen (HBO) therapy should report this service using HCPCS code G0277, Hyperbaric oxygen under pressure, full body chamber, per 30 minute interval that is effective January 1, 2015. The following may be included in calculating the total number of 30-minute intervals billable under G0277: (1) time spent by the patient under 100% oxygen; (2) descent; (3) airbreaks; and (4) ascent.
NOTE: A physician order for a 90-minute HBO treatment typically means that the physician desires that the patient be placed under 100% oxygen for 90 minutes. In order to safely achieve 100% oxygen for 90 minutes, additional time may be needed to provide for the descent, airbreaks, and ascent. Therefore, the total number of billable 30-minute intervals would not be based solely on the amount of time noted on the physician order. In calculating how many 30-minute intervals to report, hospitals should take into consideration the time spent under pressure during descent, airbreaks, and ascent. Additional units may be billed for sessions requiring at least 16 minutes of the next 30-minute interval. For example, 2 units of HCPCS code G0277 should be billed for a session in duration of between 46 and 75 minutes, while 3 units should be billed for a session in duration of between 76 and 105 minutes. Furthermore, 4 units of HCPCS code G0277 should be billed for a session in duration of between 106 and 135 minutes. HBO is typically prescribed for an average of 90 minutes, which hospitals should report using appropriate units of HCPCS code G0277 in order to properly bill for full body HBO therapy. In general, we do not expect that a physician order for 90 minutes of HBO therapy would exceed 4 billed units of HCPCS code G0277.
CMS Manual System: Pub 100-04 Medicare Claims Processing: Transmittal 3280