Commission for Case Manager Certification (CCMC) Practice Exam

Medicare guidelines stipulate that for coverage of home oxygen therapy, a patient's oxygen saturation level must be at or below a certain threshold when at rest on room air. The correct level for Medicare coverage is 88%.

This requirement is based on clinical evidence suggesting that a saturation level of 88% or lower indicates that the patient may be experiencing significant respiratory distress or hypoxemia, warranting the need for supplemental oxygen. Patients who demonstrate this level of oxygen saturation are likely to benefit from home oxygen therapy to help improve their quality of life and prevent complications associated with low oxygen levels.

Oxygen saturation levels above 88%, such as those at 90%, 85%, or 92%, do not typically qualify a patient for Medicare coverage of home oxygen, as these levels suggest that the patient's respiratory function is maintained adequately without supplemental oxygen.