Multi-Function Ventilator Reimbursement Comparison

Select Your State:

Select Your Prescribed Therapies:

Any patient that qualifies for a ventilator and at least one of the four additional functions may be eligible for VOCSN under Medicare Part B.

Back to Reimbursement Tool Form Back

Multi-Function Ventilator Reimbursement Comparison

Your State:

[State]

[State] E0467 Monthly Fee Schedule:

[$]

60 Month Reimbursement Comparison

Multi-Function Ventilator

Multi-Function Ventilator
[$] over 60 months

Traditional Devices

Ventilator Oxygen Cough Suction Nebulizer
[$] over 60 months

Total reimbursement for the VOCSN Multi-Function Ventilator will be [$] [more or less] than traditional device reimbursement over a 60 month period. This amounts to [$] [more or less] per month, averaged over 60 months.

The Medicare Part B final rule classifies multi-function ventilators in the "frequent and substantial servicing" payment category, meaning suppliers providing VOCSN to eligible beneficiaries would receive a monthly rental fee that covers the ventilator and its integrated therapies. Some of the advantages of this policy include:

Single HCPCS Code and Single Payment Methodology

VOCSN will be reimbursed according to a lump-sum monthly payment for as long as the device is medically necessary (similar to how a traditional ventilator is reimbursed today), rather than the current system that reimburses suppliers for a separate HCPCS code for each of the five therapies, with each code reimbursed under a different methodology (including capped items, which are reimbursed for up to 13 months (cough, suction, nebulizer); and oxygen equipment reimbursed up to 36 months). VOCSN is not classified as a capped rental item or as oxygen equipment.

Single Owner of Equipment

The DME supplier will own all five therapies. This is a change from the current system, which allows the supplier to own only the ventilator and oxygen concentrator whereas the beneficiary, after 13 months, would own and maintain the cough, suction, and nebulizer items.

For more information, visit www.VentecLife.com/E0467.

*Based on non-rural rates

**This information is intended to serve as general reference and does not constitute reimbursement or legal advice. Ventec Life Systems makes no promise or guarantee that the information provided is comprehensive, will remain timely, will be appropriate for the specific services provided, or will result in reimbursement. For all coding, coverage, and reimbursement matters or questions, Ventec Life Systems recommends that you consult with certified coders, payers, and/or reimbursement specialists.

Get VOCSN