Prosthetics/Orthotics & Supplies Fee 
Schedule updated by the consumer 
price index for all urban consumers 
(United States city average) for years 
2016 through 2025. 
‘‘(III) UPDATE
MECHANISM.— 
Beginning on January 1, 2027, the 
payment amount described in sub-
clause (I) shall be increased annually 
by the projected percentage increase 
in the consumer price index for all 
urban consumers (United States city 
average) for the 12-month period end-
ing December 31 of the previous year. 
‘‘(ii) 
CONSIDERATIONS.—In 
imple-
menting the payment amount under this 
subparagraph, the Secretary shall take into 
account the cost of liquid oxygen on a per 
pound basis, the cost of liquid oxygen 
equipment, the infrastructure costs associ-
ated with providing liquid oxygen equip-
ment and supplies (including labor, stor-
age, 
transportation, 
maintenance, 
and 
similar costs), the cost of complying with 
Federal and State regulations specific to 
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the delivery and transportation of liquid 
oxygen, and any other cost factors the Sec-
retary deems appropriate after consulting 
with stakeholders such as suppliers, pro-
viders, patients and patient advocates, and 
manufacturers. 
‘‘(iii) MONTHLY
ADD-ON
FOR
HIGH- 
FLOW PATIENTS.— 
‘‘(I) IN
GENERAL.—Subject to 
subclause (II), the Secretary shall es-
tablish a non-budget neutral add-on to 
the payment amount under clause (i) 
when the prescribing practitioner or-
ders an oxygen flow rate equal to or 
greater than 6 liters per minute. 
‘‘(II) 
ADD-ON
AMOUNT.—The 
add-on amount shall equal the per 
pound cost of the oxygen exceeding 
the amount required to provide a liter 
flow that is equal to or greater than 
6 liters per minute. 
‘‘(iv) PERIODIC ASSESSMENT OF THE 
BASE RATE.—The Secretary shall assess at 
least once every 3 years the adequacy of 
the payment amounts under this subpara-
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graph on a cost-related basis or other eco-
nomical and equitable basis. 
‘‘(v) TRANSITIONAL
INTERIM
PAY-
MENT.— 
‘‘(I) IN
GENERAL.—For items 
and services furnished on or after the 
date of the enactment of the SOAR 
Act of 2025 and prior to the imple-
mentation of the payment amount es-
tablished under this subparagraph, 
the Secretary shall adopt a transi-
tional interim payment amount for 
liquid oxygen, and liquid oxygen 
equipment, supplies, and services in 
an amount equal to 200 percent of 
the 2015 Durable Medical Equipment, 
Prosthetics/Orthotics & Supplies Fee 
Schedule updated by the consumer 
price index for all urban consumers 
(United States city average) for years 
2016 through 2025. 
‘‘(II) 
UPDATE.—This 
amount 
shall be updated annually by the pro-
jected percentage change in the con-
sumer price index for all urban con-
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sumers (United States city average) 
for the 12-month period ending on 
December 31 of the previous year, 
until the Secretary implements the 
payment amount under this subpara-
graph. 
‘‘(vi) COVERAGE CRITERIA.— 
‘‘(I) IN
GENERAL.—Not later 
than January 1, 2026, the Secretary, 
in consultation with stakeholders, 
shall establish objective clinical cri-
teria for the coverage of liquid oxygen, 
and liquid oxygen equipment, supplies, 
and services under this title. 
‘‘(II) UPDATE
OF
CRITERIA.— 
The Secretary shall review and update 
the coverage standards under this 
clause every 5 years to ensure the 
standards take into consideration cur-
rent medical and clinical guidelines 
and take into effect modality in order 
to maximize beneficiary independ-
ence.’’. 
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SEC. 102. ESTABLISHMENT OF SUPPLEMENTAL OXYGEN RE-
SPONSIBILITIES CRITERIA. 
(a) IN GENERAL.—Section 1834(a)(9) of the Social 
Security Act (42 U.S.C. 1395m(a)(9)), as amended by 
section 101(b), is further amended by inserting the fol-
lowing new subparagraph: 
‘‘(G) OXYGEN
AND
OXYGEN
RELATED 
EQUIPMENT, 
SUPPLIES, 
AND
SERVICES.—In 
consultation with stakeholders, the Secretary 
shall define the scope of services a supplier of 
oxygen and oxygen related equipment, supplies, 
and services must provide to receive payment 
under this part, to include— 
‘‘(i) conducting an initial evaluation of 
the beneficiary using the uniform oxygen 
patient evaluation form described in para-
graph (5)(G) to determine the appropriate 
use of oxygen and oxygen related equip-
ment, supplies, and services by the bene-
ficiary, including the use of portable equip-
ment; 
‘‘(ii) ensuring the beneficiary has ap-
propriate access to portable oxygen, and 
portable oxygen equipment, supplies, and 
services based on the mobility needs of the 
beneficiary, including the needs of the ben-
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eficiary outside the home of the bene-
ficiary; 
‘‘(iii) providing written and verbal 
beneficiary and caregiver education regard-
ing oxygen and oxygen related equipment, 
supplies, and services, stationary and port-
able options, and oxygen safety, which in-
cludes evaluating the environment of the 
beneficiary for safety risks or hazards, 
such as fire and fall hazards; 
‘‘(iv) providing appropriate delivery, 
set-up, and coordination of oxygen services 
(including the delivery of any oxygen 
equipment or supplies to a beneficiary 
prior to such beneficiary being discharged, 
delivering such equipment, and setting up 
the equipment), as needed, in a timely 
manner as agreed upon by the beneficiary 
or caregiver, supplier, and prescribing 
practitioner; 
‘‘(v) evaluating the ability of the bene-
ficiary to operate the equipment safely and 
effectively; 
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‘‘(vi) providing infection control infor-
mation and instructions about all equip-
ment and supplies; 
‘‘(vii) 
providing 
equipment-related 
services, including checking oxygen system 
purity levels and flow rates, changing and 
cleaning filters, and assuring the integrity 
of alarms and back-up systems, consistent 
with the manufacturer specifications and 
in accordance with all Federal, State, and 
local laws and regulations; 
‘‘(viii) monitoring visits when nec-
essary by appropriate personnel, including 
a respiratory therapist to evaluate all as-
pects of the services being provided to the 
beneficiary by the provider; 
‘‘(ix) documenting exception reporting 
by the supplier to the prescribing physician 
when changes occur in the compliance of 
the beneficiary with the beneficiary’s plan 
of care; 
‘‘(x) providing, as needed, continued 
education to the beneficiary or caregiver 
regarding appropriate oxygen equipment 
maintenance practices and performance; 
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‘‘(xi) providing, as prescribed by the 
plan of care of the prescribing practitioner, 
appropriate oxygen and oxygen related 
equipment, supplies, and services (includ-
ing supplemental supplies and emergency 
oxygen back-ups as appropriate); 
‘‘(xii) ensuring oxygen and oxygen 
equipment can be used appropriately out-
side the home of a beneficiary based on ne-
cessity; 
‘‘(xiii) providing 24-hour on-call cov-
erage to respond to beneficiary needs relat-
ing to oxygen and oxygen related equip-
ment, supplies, and services; and 
‘‘(xiv) assisting the beneficiary with 
the coordination of oxygen and oxygen re-
lated equipment, supplies, and services, in-
cluding by assisting the beneficiary find a 
different supplier if the beneficiary tempo-
rarily travels outside of the service area of 
the supplier. If the beneficiary relocates 
permanently, the new supplier caring for 
the beneficiary will assume responsibility 
for billing the Medicare program directly.’’. 
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(b) EFFECTIVE DATE.—The amendment made by 
this section shall take effect on the date that is 1 year 
after the date of enactment of this Act. 
SEC. 103. TECHNICAL CORRECTIONS. 
Section 1861(n) is amended by striking ‘‘iron lungs, 
oxygen tents’’ and inserting ‘‘oxygen and oxygen related 
equipment, supplies, and services’’. 
TITLE 
II—PROTECTING 
BENE-
FICIARY 
ACCESS 
TO 
RES-
PIRATORY THERAPISTS 
SEC. 201. REIMBURSEMENT FOR RESPIRATORY THERA-
PISTS. 
(a) PROTECTING ACCESS TO RESPIRATORY THERA-
PIST SERVICES.— 
(1) ADDING
RESPIRATORY
THERAPIST
SERV-
ICES TO THE DEFINITION OF MEDICAL AND OTHER 
HEALTH SERVICES.—Section 1861(s)(2) of the So-
cial Security Act (42 U.S.C. 1395x(s)(2)) is amend-
ed— 
(A) in subparagraph (JJ), by inserting 
‘‘and’’ after the semicolon; and 
(B) by adding at the end the following new 
subparagraph: 
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‘‘(KK) respiratory therapist services (as 
defined in subsection (nnn)) furnished on or 
after January 1, 2026.’’. 
(2) DEFINITION OF RESPIRATORY THERAPIST 
SERVICES.—Section 1861 of the Social Security Act 
(42 U.S.C. 1395x) is amended by adding at the end 
the following new subsection: 
‘‘(nnn) RESPIRATORY THERAPIST SERVICES.—The 
term ‘respiratory therapist services’ means services per-
formed by a respiratory therapist within the scope of prac-
tice of a respiratory therapist as defined by State law, reg-
ulations, and applicable accreditation standards for the as-
sessment, treatment, and monitoring of patients requiring 
oxygen and oxygen related equipment, supplies, or serv-
ices.’’. 
(b) 
ADD-ON
PAYMENT
ADJUSTMENT.—Section 
1834(a)(9) of the Social Security Act (42 U.S.C. 
1395m(a)(9)), as amended by sections 101(b) and 102(a), 
is further amended by adding at the end the following new 
subparagraph: 
‘‘(H) MONTHLY
PAYMENT
ADD-ON
AD-
JUSTMENT FOR RESPIRATORY THERAPIST SERV-
ICES.—For respiratory therapist services fur-
nished on or after January 1, 2026, the Sec-
retary shall implement through notice and com-
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ment rulemaking and in consultation with 
stakeholders a non-budget neutral add-on pay-
ment adjustment to the payment amount estab-
lished under this paragraph that reflects the 
cost of providing respiratory therapist services 
as clinically appropriate under State law.’’. 
TITLE III—ADOPTION OF ELEC-
TRONIC 
TEMPLATES 
TO 
STRENGTHEN 
FRAUD 
AND 
ABUSE 
PROTECTIONS 
AND 
ENSURE 
PROGRAM 
INTEG-
RITY 
SEC. 
301. 
STRENGTHENING 
PROGRAM 
INTEGRITY 
THROUGH THE USE OF ELECTRONIC TEM-
PLATES TO DOCUMENT MEDICAL NECESSITY, 
AND RESTORING CLINICAL INFERENCE FOR 
OXYGEN AND OXYGEN RELATED EQUIPMENT, 
SUPPLIES, AND SERVICES. 
(a) ADOPTING ELECTRONIC TEMPLATES FOR DE-
TERMINING MEDICAL NECESSITY.—Section 1834(a)(5) of 
the Social Security Act (42 U.S.C. 1395m(a)(5)) is 
amended by adding at the end the following: 
‘‘(G) ADOPTION
OF
ELECTRONIC
TEM-
PLATES
TO
DOCUMENT
MEDICAL
NECESSITY 
AND STRENGTHEN PROGRAM INTEGRITY.— 
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‘‘(i) IN
GENERAL.—For any oxygen 
and oxygen related equipment, supplies, or 
service, including liquid oxygen, furnished 
on or after January 1, 2026, the Secretary 
shall adopt a template in an electronic for-
mat that meets the requirements of clause 
(ii) to be completed by the prescribing 
practitioner (as defined by the Secretary) 
that shall constitute the complete request 
for information to determine whether pay-
ment for such service, equipment, or sup-
plies is covered by this title and is reason-
able and necessary for the diagnosis or 
treatment of illness or injury (under sec-
tion 1862(a)(1)(A)). 
‘‘(ii) TEMPLATE
REQUIREMENTS.— 
The template shall require the prescribing 
practitioner to provide each of the fol-
lowing: 
‘‘(I) Documentation that the ben-
eficiary was seen by a prescribing 
practitioner within the appropriate 
timeframes for certification of the 
need for the services, equipment, or 
supplies. 
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