Medicare home oxygen cost: the 36-month rental and what you pay

That 36-month figure is the whole rental. Month 37 brings no new equipment charge for a concentrator, because Medicare stops paying rent on it, and no transfer of ownership either. A CPAP works the opposite way: Medicare rents it for 13 months and then title passes to you, which the CPAP rental guide walks through. Oxygen has its own payment section in the regulation, 42 CFR 414.226, and its own statute, section 1834(a)(5) of the Social Security Act, so the CPAP arithmetic does not carry over. Beds, wheelchairs, commodes and walkers are paid under the capped rental and inexpensive-item classes instead; the walker, wheelchair and hospital bed cost guide prices them from the same fee schedule download.

The oxygen payment rules, dated and cited

Each line below comes from the regulation text current on eCFR as of October 29, 2026, the DME MAC policy article for oxygen (A52514, version 61), or the background file CMS ships with the 2026 fee schedule. The section was last amended at 83 FR 57071 (November 14, 2018), the rule that set up the payment classes used since 2019; the rental cap itself dates from the Medicare Improvements for Patients and Providers Act of 2008, effective January 1, 2009, according to the CMS background file.

The "24 months" in the supplier-duty row is arithmetic, not a separate rule. The regulation ties the duty to the remainder of the 5-year lifetime, and the lifetime runs from the first delivery. If billing paused for a hospital stay, the 36th payment lands later than calendar month 36, and the remaining time is shorter than 24 months.

The October 2026 monthly amounts, code by code

The amounts below are the Medicare-approved monthly fee schedule figures from CMS file DMEPOS_OCT.csv in the October 2026 release (DME26-D), downloaded and checked 2026-10-31. Each row is the plain code with no flow-rate modifier. Equipment codes carry the RR (rental) modifier; contents codes carry none. Michigan and Florida are shown for their non-rural and rural ZIP columns.

Three things in that table drive most bills. First, every stationary option pays the same: a concentrator, a gaseous stationary system and a liquid stationary system are all $99.31 in non-rural Michigan, because 42 CFR 414.226(e)(1)(i) puts them in one payment class. Second, the portable codes do not. Plain portable gas tanks (E0431) are $22.12, while a portable concentrator (E1392), a home transfill system for gas cylinders (K0738), a home liquid fill system (E0433) and a portable liquid system (E0434) are each $46.28. Third, the contents codes look large next to the equipment codes, but you do not see them during the first 36 months, because contents are already inside the stationary payment.

The policy article also limits how codes combine. When K0738 (transfill for gas cylinders) is billed, E0431 must not be; when E0433 (home liquid fill) is billed, E0434 must not be. A statement that shows both lines of either pair for the same month is worth a call to the supplier.

Your 20 percent, month by month and over five years

The figures below assume the Part B deductible has already been met by other claims and that the supplier accepts assignment. Each monthly claim is figured separately, so the 20 percent is rounded to the cent on each claim, then multiplied. Michigan non-rural amounts throughout.

The concentrator with a portable concentrator, step by step: 20 percent of $99.31 is $19.86, and 20 percent of $46.28 is $9.26. Together that is $29.12 a month, and 36 months of it is $1,048.32. In month 37 both rental lines stop. Nothing on the five-year line for that setup includes a servicing visit, because no servicing amount appears in the October file used for this page; that gap is covered in the next section.

The tank setups end up costing more over five years even though their rent is lower or equal. A gaseous stationary system with gas tanks runs $874.08 over the rental, then $13.51 plus $12.13 a month for contents in months 37 to 60, which adds $615.36. That is why the 36-month figure alone understates a tank user's bill: the contents lines in years four and five are close to the rental share in years one to three.

The concentrator with delivered gas tanks sits in between. Under the policy article, when you used portable gas tanks in month 36 of the stationary rental, portable contents (E0443) start in month 37, while the concentrator itself needs no contents. Your share in months 37 to 60 is $12.13 a month, or $291.12.

The deductible in a year with no other Part B claims

If oxygen is your only Part B claim in a calendar year, you pay the first $283.00 of approved amounts in full, instead of 20 percent of it. That costs $226.40 more than the deductible-met figures above, once per calendar year. For the concentrator plus portable concentrator in a year with twelve rental months and nothing else billed to Part B, your share would be $575.82: the $283.00 deductible plus 20 percent of the remaining approved amount. In most years, other Part B claims meet the deductible first.

What still bills in months 37 to 60

Medicare.gov describes the back half of the lifetime in one sentence: after 36 months of rental payments, payment for the equipment ends, but Medicare continues to pay the supplier to give you oxygen and equipment for as long as you need it, up to 5 years after you started. That ongoing payment takes two forms, and which one you see depends on your system.

Contents claims for tanks and liquid

If you were on gaseous or liquid equipment in month 36, the stationary rental ends and contents claims begin. The policy article caps them at one unit of stationary contents and one unit of portable contents per month, says no more than 3 months of contents may be delivered at once, and says the payment does not change with flow rate, so a high-flow patient's contents claim is the same amount as anyone else's, with one exception. Portable liquid contents for a prescribed flow over 4 liters per minute have their own code, E0447, at $90.98 in non-rural Michigan, against $60.65 for E0444. That code exists because 42 CFR 414.226(e)(1)(vii) sets it up as a separate payment class, based initially on 150 percent of the ordinary portable contents rate.

The supplier also has a duty here. Under 42 CFR 414.226(h)(2), the supplier that furnished gaseous or liquid equipment in month 36 must keep supplying the contents for the rest of the lifetime, or arrange another supplier if you move outside its area. The policy article adds that the supplier must provide whatever quantity of contents you need for activities inside and outside the home.

Servicing visits for concentrators and transfill units

For a stationary concentrator, a portable concentrator or transfill equipment, there are no contents, so the only possible Medicare claim in months 37 to 60 is a maintenance and servicing visit. The policy article allows one paid visit every 6 months, the first no sooner than 6 months after the rental ends; if a warranty covers routine labor, the first visit waits until 6 months after the warranty ends. The supplier must actually visit to bill it, and extra visits inside one 6-month window are not paid. Medicare.gov adds the patient side: if you have to pay, your coinsurance begins 6 months after the 36-month period, and the supplier cannot charge you for the service unless it comes to your home.

The October 2026 statewide file used for this page lists no oxygen line with an MS (maintenance and servicing) modifier, so this page does not print a dollar figure for the visit. Ask the supplier, before month 36, whether it bills servicing visits and what the approved amount is. A 20 percent coinsurance on a visit twice a year is the most you should see for a concentrator in years four and five.

The regulation's own servicing paragraph, 42 CFR 414.210(e)(2), still carries its original date window of January 1, 2009 through June 30, 2010. The current every-6-months rule is the one in the CMS background file and the policy article, which is why the table above cites those.

Portable equipment that started later

One exception lets a portable rental run past the stationary one. If the portable began after the stationary equipment, the policy article says the portable rental continues until it reaches its own 36 payments, even after the stationary rental has ended. So a patient who added a portable concentrator in month 10 keeps seeing an E1392 line, and a $9.26 share in non-rural Michigan, through month 45.

High flow: the QB and QF rows

When the prescribed flow rate exceeds 4 liters per minute, 42 CFR 414.226(g)(1) raises the stationary fee schedule amount by 50 percent, and when it is under 1 liter per minute, it cuts the amount by 50 percent. Paragraph (g)(2) then sets a limit for patients who also use a portable: the total paid is the higher of the stationary plus portable amounts, or the stationary amount increased by 50 percent. The policy article tells suppliers to show this with modifiers: QF when the at-rest flow exceeds 4 liters per minute and portable oxygen is prescribed, QB when day and night flow rates differ, their average exceeds 4, and a portable is prescribed.

The October 2026 file prints the result of that limit on the portable line, not the stationary one, which can look odd on a statement. The stationary rows with QB or QF are the same as the plain rows: E1390 QF is $99.31 in non-rural Michigan. The portable rows with QB or QF all jump to $49.66, whether the portable is gas tanks, a portable concentrator or a transfill unit. That $49.66 is exactly half of $99.31, rounded to the cent.

Checking the limit by hand: the stationary amount plus 50 percent is 1.5 x $99.31, or $148.97. The plain pair, $99.31 plus $46.28, is $145.59. The higher of the two is $148.97, which matches the file's QF pair of $99.31 plus $49.66. The same holds in rural Michigan, where $177.16 plus the QF portable row of $88.58 equals 1.5 times $177.16.

The file has no rows for the QG modifier (over 4 liters per minute, no portable) or the QE modifier (under 1 liter per minute). Applying the 50 percent rule in paragraph (g)(1) to the non-rural Michigan concentrator gives $148.97 with QG and $49.66 with QE. Those two figures are MyCarePrice arithmetic from the rule, not amounts printed in the CMS file, and the claims system may round them differently. A low-flow patient on QE would see a 20 percent share near $9.93 a month.

The flow rate used is set by rule, which matters when a statement does not match what you expected. If the stationary and portable flow rates differ, the stationary one counts. If the rates at rest and with exercise differ, the at-rest rate counts, and the policy article tells suppliers not to use an exercise test for QF or QG. If day and night rates differ, they are averaged.

Rural ZIPs and former bidding areas: the concentrator's price spread

The same concentrator has a different approved amount depending on your ZIP. Rural ZIPs outside former bidding areas are paid on a blend of 50 percent of the bid-adjusted amount and 50 percent of the older unadjusted amount, under 42 CFR 414.210(g)(2), as the CMS background file explains. Non-rural ZIPs outside former bidding areas are paid at 100 percent of the adjusted amount since January 1, 2024. Former bidding areas are paid on their own single payment amounts, carried forward with inflation (see the next section).

The spread runs from $685.08 over 36 months in the Flint former bidding area to $1,275.48 in a rural Michigan or Florida ZIP. A rural Michigan patient pays $560.52 more over the rental than a non-rural one, for the same code and the same rules. The Miami former bidding area, at $832.32, sits above the Florida non-rural column. Which column applies depends on the ZIP where you live, which the CMS rural ZIP and former bidding area ZIP files decide; the supplier's billing office can tell you which one it used.

Competitive bidding status, checked October 31, 2026

No competitive bidding contracts for oxygen are in effect. The CMS competitive bidding page (last modified 2026-04-06) says that the Round 2021 contracts, which covered only off-the-shelf back braces and knee braces, expired on December 31, 2023, and that a temporary gap period has been in place since January 1, 2024. During the gap, CMS sets fees in former bidding areas at 100 percent of the area's last single payment amount, increased by the projected change in the Consumer Price Index for All Urban Consumers.

The next round is Round 2028. The bidding contractor's product category page, updated 2026-06-04, lists seven categories: Class II CGMs and insulin pumps, Hydrophilic urinary catheters, Ostomy supplies, OTS back braces, OTS knee braces, OTS upper extremity braces, Urological supplies. Oxygen is not among them. The contractor's timeline gives target dates only: the bid window in late fall 2026, contracts announced in late summer or early fall 2027, and contracts and single payment amounts in effect no later than January 1, 2028. If oxygen were added in a later round, the policy article says a patient living in a bidding area could get replacement equipment at the end of a 5-year lifetime only from a contract supplier for that area.

Coverage rules are under review separately. A proposed revision to the oxygen LCD (DL33797) was posted on July 16, 2026, and its comment period ended September 5, 2026. As of October 31, 2026, the Medicare Coverage Database still lists L33797 version 50 as the active LCD and shows no final revision. An LCD sets who qualifies; the monthly amounts on this page come from the fee schedule and the payment regulation.

Breaks, moves and supplier changes

The 36 months are payments, not calendar months, and several common events change when the last one lands.

• Hospital or nursing facility stay. If you still need oxygen during an inpatient or skilled nursing stay, the policy article calls it a break in billing, not a break in need. The home supplier does not bill those months, and the count resumes on your return. The same applies to months spent in a Medicare Advantage plan before returning to Original Medicare.
• Need ends, then returns. Under 42 CFR 414.230(c), an interruption of up to 60 consecutive days plus the rest of the rental month is temporary, and payments pick up where they stopped. A longer gap, with a new order and new documentation under 414.230(d), starts a fresh 36 months, but only if it happens during the first 36 months. In months 37 to 60, the policy article says a long break does not start a new rental, and the month-36 supplier keeps its duty.
• Moving or traveling. A move does not interrupt continuous use under 42 CFR 414.230(e). In months 1 to 36, the home supplier must cover the rest of a billed month away, and is encouraged to arrange a supplier in the new area after that. In months 37 to 60, it must furnish the equipment itself or arrange another supplier. Oxygen supplied by an airline is not covered, and the policy article puts that cost on the patient.
• Switching suppliers. Changing suppliers does not restart the 36 months. A new supplier picks up the count where the old one stopped, so it is paid only for the months left.
• Equipment swaps. A supplier may not switch you to a different type of system unless it replaces like with like, a treating practitioner orders a change, CMS or the DME MAC approves it, or you choose an upgrade and sign an Advance Beneficiary Notice. The ABN guide explains what signing that form means for your bill. Wear and tear, repairs and upgrades do not start a new rental.

Lifetime cost across ten years of oxygen

A patient who needs oxygen for longer than five years goes through more than one cycle. Medicare.gov says there is no limit on the number of times you can get replacement equipment, and that it does not have to come from the same supplier. Each new set of equipment starts a new 5-year lifetime and a new 36-month rental, under 42 CFR 414.210(f)(2) and 414.226(a).

At October 2026 rates, a concentrator plus portable concentrator in non-rural Michigan costs the patient $1,048.32 in each 36-month rental and nothing for equipment in months 37 to 60, apart from any servicing visits. Two cycles over ten years come to $2,096.64 in 20 percent shares. That is an illustration only: CMS updates the fee schedule every quarter, so a rental starting in 2031 will use whatever amounts are current then.

The choice at year five is yours. The policy article says that if you keep the old equipment and the supplier keeps title, the months 37 to 60 rules continue: no rent, no separate accessory or repair payment, and contents if you are on gas or liquid. If the supplier transfers title to you instead, accessories, maintenance and repairs become non-covered, though contents for an owned gas or liquid system remain payable. Taking new equipment restarts the 20 percent rental share. Ask the supplier, in writing, which of those it is offering before the lifetime ends.

The written assignment promise, and who else can pay the share

Every figure above assumes the supplier accepts assignment, which means it takes the Medicare-approved amount as payment in full and bills you only the 20 percent. The regulation requires the supplier to disclose, before furnishing oxygen, whether it will accept assignment of all monthly rental claims for the rental period, and says that can take the form of a written agreement. Medicare.gov's oxygen page tells patients to ask whether a supplier participates in Medicare or will accept assignment before getting equipment.

A Medigap policy may pay some or all of the 20 percent, depending on its plan letter. A Medicare Advantage plan sets its own cost sharing and network for oxygen, so the fee schedule amounts here are a reference point only; ask the plan for the copay or coinsurance on E1390 and the portable code you will use. Lower-income beneficiaries may qualify for help with Part B cost sharing: the Medicare Savings Programs guide explains which programs pay the Part B premium, deductible and coinsurance.

When a statement arrives, match it against three things: the HCPCS code and modifier on each line, whether the month count matches the rental month you are in, and whether a contents line appears in a month that also has a stationary rental line. The policy article says contents cannot be paid in a month when stationary equipment is paid, so that combination should not appear.

Home oxygen rental questions

Sources for the oxygen figures

• CMS, DMEPOS fee schedule DME26-D (October 2026 quarter), dme26-d.zip: DMEPOS_OCT.csv (Michigan and Florida non-rural and rural columns), Former CBA Fee Schedule File - OCT2026.csv (Detroit, Flint, Grand Rapids, Miami, Orlando and Tampa), DMEREAD 2026.pdf (QB and QF modifier definitions) and DMEBACK 2026.pdf (oxygen payment rules, 36-month cap, servicing every 6 months, rural blend, former bidding area method). Every E-code and K-code amount on this page. Checked 2026-10-31.
• eCFR, 42 CFR 414.226 (oxygen payment classes, 36-month cap, volume adjustments, supplier duties after the cap, assignment disclosure; last amended at 83 FR 57071, November 14, 2018), 42 CFR 414.210 (5-year minimum useful lifetime, replacement, servicing paragraph) and 42 CFR 414.230 (continuous use, 60-day interruptions, moves), current as of October 29, 2026. Read through the eCFR API, checked October 31, 2026.
• DME MACs (CGS and Noridian), Policy Article A52514, Oxygen and Oxygen Equipment, version 61 (useful lifetime, months 1 to 36, 37 to 60 and 61 on, contents, servicing, travel, breaks in service, QA to QR modifiers, K0738 and E0433 coding). Checked October 31, 2026.
• DME MACs, LCD L33797, Oxygen and Oxygen Equipment, version 50, effective April 1, 2023, and the proposed LCD DL33797 (comment period ended September 5, 2026). Status checked October 31, 2026.
• Medicare.gov, Oxygen equipment and accessories (36-month rental, supplier duty up to 5 years, servicing coinsurance every 6 months, replacement after 5 years, assignment) and Medicare costs (2026 Part B deductible of $283.00). Checked October 30 and 31, 2026.
• CMS, DMEPOS Competitive Bidding (temporary gap period since January 1, 2024; page last modified April 6, 2026), and the Competitive Bidding Implementation Contractor's Round 2028 product categories and Round 2028 timeline (both updated June 4, 2026). Checked October 31, 2026.

General billing information, not medical, legal or insurance advice. DMEPOS fee schedule amounts are Medicare anchors, not your bill. A supplier that does not accept assignment, a Medicare Advantage plan or a supplement can change what you pay. Confirm your price in writing before service.