Prescribing Oxygen for Cluster Headache: A Guide for the Provider

Authors: Stewart J. Tepper MD, FAHS, Jessica Duplin RN, Barbara Nye MD, Deborah E. Tepper MD
Source: Headache, 30 August 2017

Abstract

Background

Oxygen is the standard of care for acute treatment of cluster headache. CMS, the US Centers for Medicaid and Medicare Services, has made the indefensible decision to not cover oxygen for cluster headache for patients with Medicaid and Medicare insurance, despite the evidence and professional guidelines. Commercial insurance generally covers oxygen for cluster headache.

Objective

This is a “how-to” guide for successfully prescribing oxygen in the US.

Summary

Prescription information is provided that can be incorporated as dot phrases, smart sets, or other standard templates for prescribing oxygen for cluster patients. In many states, oxygen is affordable and can be prescribed for Medicaid and Medicare patients who wish to pay cash. Welding or non-medical grade industrial oxygen is almost the same cost as medical oxygen. However, it is less pure, lacks the same inspection of tanks, and is delivered without regulators to provide appropriate flow rates. Patients who pay cash should be strongly encouraged to buy medical oxygen.

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