Medicare Coverage Update: Proposed LCD for Topical Oxygen Therapy Issued

Update on Proposed Medicare Coverage Determination for Topical Oxygen Therapy

We are pleased to share that the DME Medicare Administrative Contractors (DME MACs) have released the long-awaited proposed Local Coverage Determination (LCD DL33797) addressing Topical Oxygen Therapy (TOT). This represents a significant milestone following the LCD reconsideration process initiated in 2021.

The proposed LCD establishes reasonable and necessary coverage criteria for topical oxygen therapy for Medicare beneficiaries with diabetic foot ulcers that have failed to heal after four consecutive weeks of optimized care. While this is a proposed coverage determination and not yet final, it represents an important step toward expanding Medicare access to topical oxygen therapy based on the current body of clinical evidence.

Our team is conducting a comprehensive review of the proposal to assess its clinical, operational, and reimbursement implications. We are working closely with clinical experts, key stakeholders, and the Alliance of Wound Care Stakeholders to develop a formal response during the 45-day public comment period, with the goal of supporting a final coverage determination that reflects current clinical practice, the strength of the available evidence, and appropriate patient access.

We appreciate the efforts of the many clinicians, researchers, patient advocates, and industry stakeholders who have contributed to advancing the evidence base for topical oxygen therapy and to reaching this important stage in the Medicare coverage process. Click here to read more.