Oxygen and Oxygen Equipment
National · Effective Apr 1, 2023
5 active Medicare policies list A4575, and 15 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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National · Effective Apr 1, 2023
JJ · Effective May 6, 2019
JM · Effective May 6, 2019
National · Effective Oct 2, 2025
National · Effective Mar 4, 2021
15 policies from 11 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of A4575 |
|---|---|---|
| Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments | Feb 20, 2024 | Covered |
| Autism Spectrum Disorders | Dec 5, 2023 | Covered |
| Hyperbaric Oxygen Therapy (HBOT) | Apr 6, 2023 | Covered |
| Infertility | Feb 15, 2024 | Covered |
| Skin and Soft Tissue Substitutes | Feb 9, 2024 | Covered |
| Policy | Effective | Status of A4575 |
|---|
| Hyperbaric Oxygen Therapy (Systemic/Topical) | Jun 28, 2024 | Covered |
|---|
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen (HBO2) Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen (HBO2) Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen (HBO2) Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen (HBO2) Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric and Topical Oxygen Therapies | May 15, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen Therapy | Jan 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen Therapy and Topical Oxygen Therapy | May 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen Therapy and Topical Oxygen Therapy | May 1, 2026 | Covered |
| Policy | Effective | Status of A4575 |
|---|---|---|
| Hyperbaric Oxygen Therapy and Topical Oxygen Therapy | May 1, 2026 | Covered |