36C26126Q0420.pdf

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Home Oxygen - VA Northern California Healthcare System
Solicitation number
36C26126Q0420
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This is a Standard Form 1449 Solicitation/Contract/Order for Commercial Products and Commercial Services for Home Oxygen Services issued by the Department of Veterans Affairs Veterans Health Administration, VA Sierra Pacific Network (VISN 21), Network Contracting Office. The solicitation number is 36C26126Q0420, with an offer due date of April 21, 2026, at 10:00 AM Pacific Time. The contracting officer is David J. Alvarez (916-923-4564). This is a Service-Disabled Veteran-Owned Small Business (SDVOSB) set-aside acquisition with a guaranteed minimum award of $100.00 and a maximum ceiling of $6,000,000.00 for the entire contract period.

The contractor shall provide comprehensive Home Oxygen Services to Veteran Beneficiaries serviced by VA Northern California Healthcare System (VANCHCS) across five one-year ordering periods from October 1, 2026, through September 30, 2031. Services include rental and maintenance of portable concentrators, gaseous oxygen systems, stationary and portable liquid oxygen systems, suction pumps, ventilators, air compressors, and cylinder refills (E, D, C, M-6, and H sizes, plus liquid oxygen). The Performance Work Statement requires The Joint Commission (TJC) accreditation or equivalent standards; certified respiratory therapist (CRT) or registered respiratory therapist (RRT) personnel with at least two years of experience; 24/7 emergency service capability with response within 30 minutes by phone and equipment delivery within two to six hours; equipment maintenance visits every 90 days for oxygen patients and every 30 days for ventilator patients; initial setup within 24 hours of prescription receipt; and comprehensive patient education, infection control protocols, and quarterly reporting on performance metrics, customer satisfaction, falls prevention, and home visit compliance. The contractor must maintain facilities or resources physically located within 50 miles of each VA medical center, comply with all federal and state regulations, maintain appropriate insurance coverage, and adhere to HIPAA, Privacy Act, and VA information security requirements. Payment will be made electronically upon delivery and government acceptance in arrears, with invoices submitted through the VA electronic invoicing system.

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36C26126Q0420 0002 CANX.pdf PDF
Quality Assurance Surveillance Plan - 4-8-26.pdf PDF
36C26126Q0420 Questions and Responses.pdf PDF
PP Questionnaire.docx DOCX document
36C26126Q0420 CLINS Price Per Unit.xlsx XLSX spreadsheet
36C26126Q0420 0001.pdf PDF
Quality Assurance Surveillance Plan-NorCal.pdf PDF
PP Questionnaire.docx DOCX document

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PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

a. NAME b. TELEPHONE NO. (No Collect Calls) 8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY CODE 10. THIS ACQUISITION IS UNRESTRICTED OR SET ASIDE: % FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

15. DELIVER TO CODE 16. ADMINISTERED BY CODE

17a. CONTRACTOR/OFFEROR CODE FACILITY CODE 18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO. UEI: EFT:

PHONE: FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19. 20. 21. 22. 23. 24.

ITEM NO. SCHEDULE OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________ 29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION (REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C261-27-AP-0177

36C26126Q0420 03-24-2026

David J. Alvarez 916-923-4564 04-21-2026

10:00 AM

612MCP

Department of Veterans Affairs

VA Sierra Pacific Network (VISN 21)

Network Contracting Office (NCO) 21

X 100

X

532283

$41 Million

N/A

See Performance Work Statement

612MCP

Department of Veterans Affairs

Network Contracting Office (NCO) 21

3237 Peacekeeper Way, Bldg 209

McClellan CA 95652

FMS VA-9(101) Financial Services Center

PO Box 149971

Austin TX 78714-9971

See CONTINUATION Page

Contractor shall provide Home Oxygen Services in accordance with the Performance Work Statement herein.

Period of Performance:

Ordering Period One: 10/1/2026 - 9/30/2027

Ordering Period Two: 10/1/2027 - 9/30/2028

Ordering Period Three: 10/1/2028 - 9/30/2029

Ordering Period Four: 10/1/2029 - 9/30/2030

Ordering Period Five: 10/1/2030 - 9/30/2031

Questions regarding this RFQ are due by 10:00 AM PDT on 4/2/2026. Questions and quote shall be submitted by email only to david.alvarez4@va.gov.

See CONTINUATION Page

X 1

David J. Alvarez

Contracting Officer

36C26126Q0420

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.2 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (NOV 2023)(DEVIATION OCT 2025)

C.3 52.216-18 ORDERING (AUG 2020)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-22 INDEFINITE QUANTITY (NOV 2025) (DEVIATION)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.240-91 SECURITY PROHIBITIONS AND EXCLUSIONS (NOV 2025)

(DEVIATION)

C.8 52.252-6 AUTHORIZED DEVIATIONS IN CLAUSES (NOV 2020)

C.9 VAAR 852.219-73 VA NOTICE OF TOTAL SET-ASIDE FOR CERTIFIED

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESSES (JAN 2023)

(DEVIATION)

C.10 VAAR 852.219-75 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—

CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (JAN 2023)

(DEVIATION)

C.11 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) ..93

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

SECTION E - SOLICITATION PROVISIONS

E.1 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.2 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (SEP 2023)(DEVIATION OCT 2025)

E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT

2018)(DEVIATION NOV 2025)

E.4 52.216-1 TYPE OF CONTRACT (NOV 2025) (DEVIATION)

E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)(DEVIATION NOV 2025)

E.6 52.252-5 AUTHORIZED DEVIATIONS IN PROVISIONS (NOV 2020)

E.7 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)(DEVIATION OCT 2025)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C261

VA Sierra Pacific Network (VISN 21)

Network Contracting Office (NCO) 21

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

[X] 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or

[] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Upon Delivery and Government Acceptance

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment

Requests.

www.fsc.va.gov/einvoice.asp http://www.tungsten-network.com/US/en/veterans-affairs/

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

The Contractor shall provide Home Oxygen Services for the Department of Veterans Affairs in accordance with the specifications listed herein.

The guaranteed minimum award amount for this contract is $100.00. The maximum aggregate value of orders that can be placed under this contract is $6,000,000.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount. Quantities are estimates only. Each item requires a quoted price even if the item reflects a quantity of zero (0).

ITEM INFORMATION

ITEM

NUMBE

R

DESCRIPTION OF

SUPPLIES/SERVI

CES

QUANTI

TY

UNI

T UNIT PRICE AMOUNT

5,000.00 MO _______________

Rental of Contractor Owned Portable Concentrator System Priced Per Month. HCPCS CODE E1390. Concentrator, Colored Tubing, Adapter Humidifier (when required), Cannulas or Masks and other required supplies and equipment, including back up systems. Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and Supplies

MANUFACTURER PART NUMBER (MPN): N/A

4,880.00 MO _______________

Rental of Contractor Owned Portable O2 Gaseous System for use with or without Stationary System Priced Per Month.

HCPCS CODE E0431. Portable System, Regulator, Flowmeter, Humidifier, Cannulas, or Masks, Tubing, Conserving Device and O2 Tank Cylinder Stands capable of holding 12 cylinders, sizes E, D, C & M-6.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

175.00 MO _______________

Rental of Contractor Owned Stationary Liquid O2 System Priced Per Month. HCPCS CODE E0439. Reservoir, Regulator, Flowmeter, Humidifier, Cannulas or Masks, and Colored Tubing.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Liquid O2 System Priced Per Month. HCPCS CODE E0434. Portable Container, Refill Adapter Flowmeter, Cannulas or Masks, and Colored Tubing. Reservoir will be provided if another Stationary System (e.g. Concentrator) is rented.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

100.00 EA _______________

Suction Pump Priced Per Each. HCPCS CODE E0600.

Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Rental Priced Per Each. HCPCS CODE E0600. Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

80.00 MO _______________

Rental of Contractor Owned Volume Ventilator Priced Per Month. HCPCS CODE E0465. Delivery, Set-up, Training, and Maintenance of Contractor Owned Stationary or Portable Ventilator, to include back up Ventilator and all supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

12.00 EA _______________

Government Owned Ventilator Set-up Priced Per Each.

HCPCS CODE E0465. Delivery, Set-up, and Training of a Government Owned Ventilator to include all necessary supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

12.00 MO _______________

REACT V+C ventilator Priced Per Month. HCPCS CODE E0468. Maintenance of Government Owned Ventilator Systems, to include all necessary supplies.

Ordering Period: 1 POP Begin: 10-01-2026

POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Air Compressor Priced Per Month. HCPCS CODE E0465.

Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

50.00 MO _______________

Priced Per Month. E0565. Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies0 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

0.00 EA _______________

Delivery Charge Priced Per Each. HCPCS CODE A9901.

Deliveries not made under all other line items.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Respiratory Therapist Visit Priced Per Each. HCPCS CODE VA120. Government requested Respiratory Therapist visit not covered by other Line Items.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Concentrator System.

HCPCS CODE E1392. Concentrator, Colored Tubing, Adapter Humidifier (when required), Cannulas or Masks and other required supplies and equipment, including back up systems. Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable O2 Gaseous System for use with or without Stationary System Priced Per Month.

HCPCS CODE E0431. Portable System, Regulator, Flowmeter, Humidifier, Cannulas, or Masks, Tubing, Conserving Device and O2 Tank Cylinder Stands capable of holding 12 cylinders, sizes E, D, C & M-6.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Rental of Contractor Owned Stationary Liquid O2 System Priced Per Month. HCPCS CODE E0439. Reservoir, Regulator, Flowmeter, Humidifier, Cannulas or Masks, and Colored Tubing.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Liquid O2 System Priced Per Month. HCPCS CODE E0434. Portable Container, Refill Adapter Flowmeter, Cannulas or Masks, and Colored Tubing. Reservoir will be provided if another Stationary System (e.g. Concentrator) is rented.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Priced Per Each. HCPCS CODE E0600.

Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Rental Priced Per Each. HCPCS CODE E0600. Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Volume Ventilator Priced Per Month. HCPCS CODE E0465 & E0466. Delivery, Set-up, Training, and Maintenance of Contractor Owned Stationary or Portable Ventilator, to include back up Ventilator and all supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Government Owned Ventilator Set-up Priced Per Each.

HCPCS CODE E0465 & E0466. Delivery, Set-up, and Training of a Government Owned Ventilator to include all necessary supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Ventilator Maintenance Priced Per Month. HCPCS CODE E0465 & E0466. Maintenance of Government Owned Ventilator Systems, to include all supplies.

Ordering Period: 2 POP Begin: 10-01-2027

POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Air Compressor Priced Per Month. HCPCS CODE E0565.

Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Priced Per Month. E0565. Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Delivery Charge Priced Per Each. HCPCS CODE A9901.

Deliveries not made under all other line items.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Respiratory Therapist Visit Priced Per Each. HCPCS CODE VA120. Government requested Respiratory Therapist visit not covered by other Line Items.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Concentrator System.

HCPCS CODE E1392. Concentrator, Colored Tubing, Adapter Humidifier (when required), Cannulas or Masks and other required supplies and equipment, including back up systems. Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable O2 Gaseous System for use with or without Stationary System Priced Per Month.

HCPCS CODE E0431. Portable System, Regulator, Flowmeter, Humidifier, Cannulas, or Masks, Tubing, Conserving Device and O2 Tank Cylinder Stands capable of holding 12 cylinders, sizes E, D, C & M-6.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Rental of Contractor Owned Stationary Liquid O2 System Priced Per Month. HCPCS CODE E0439. Reservoir, Regulator, Flowmeter, Humidifier, Cannulas or Masks, and Colored Tubing.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Liquid O2 System Priced Per Month. HCPCS CODE E0434. Portable Container, Refill Adapter Flowmeter, Cannulas or Masks, and Colored Tubing. Reservoir will be provided if another Stationary System (e.g. Concentrator) is rented.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Priced Per Each. HCPCS CODE E0600.

Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Rental Priced Per Each. HCPCS CODE E0600. Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Volume Ventilator Priced Per Month. HCPCS CODE E0465 & E0466. Delivery, Set-up, Training, and Maintenance of Contractor Owned Stationary or Portable Ventilator, to include back up Ventilator and all supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Government Owned Ventilator Set-up Priced Per Each.

HCPCS CODE E0465 & E0466. Delivery, Set-up, and Training of a Government Owned Ventilator to include all necessary supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Ventilator Maintenance Priced Per Month. HCPCS CODE E0465 & E0466. Maintenance of Government Owned Ventilator Systems, to include all supplies.

Ordering Period: 3 POP Begin: 10-01-2028

POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Air Compressor Priced Per Month. HCPCS CODE E0565.

Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Priced Per Month. E0565. Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Delivery Charge Priced Per Each. HCPCS CODE A9901.

Deliveries not made under all other line items.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Respiratory Therapist Visit Priced Per Each. HCPCS CODE VA120. Government requested Respiratory Therapist visit not covered by other Line Items.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Concentrator System.

HCPCS CODE E1392. Concentrator, Colored Tubing, Adapter Humidifier (when required), Cannulas or Masks and other required supplies and equipment, including back up systems. Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable O2 Gaseous System for use with or without Stationary System Priced Per Month.

HCPCS CODE E0431. Portable System, Regulator, Flowmeter, Humidifier, Cannulas, or Masks, Tubing, Conserving Device and O2 Tank Cylinder Stands capable of holding 12 cylinders, sizes E, D, C & M-6.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Rental of Contractor Owned Stationary Liquid O2 System Priced Per Month. HCPCS CODE E0439. Reservoir, Regulator, Flowmeter, Humidifier, Cannulas or Masks, and Colored Tubing.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Liquid O2 System Priced Per Month. HCPCS CODE E0434. Portable Container, Refill Adapter Flowmeter, Cannulas or Masks, and Colored Tubing. Reservoir will be provided if another Stationary System (e.g. Concentrator) is rented.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Priced Per Each. HCPCS CODE E0600.

Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Rental Priced Per Each. HCPCS CODE E0600. Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Volume Ventilator Priced Per Month. HCPCS CODE E0465 & E0466. Delivery, Set-up, Training, and Maintenance of Contractor Owned Stationary or Portable Ventilator, to include back up Ventilator and all supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Government Owned Ventilator Set-up Priced Per Each.

HCPCS CODE E0465 & E0466. Delivery, Set-up, and Training of a Government Owned Ventilator to include all necessary supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Ventilator Maintenance Priced Per Month. HCPCS CODE E0465 & E0466. Maintenance of Government Owned Ventilator Systems, to include all supplies.

Ordering Period: 4 POP Begin: 10-01-2029

POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Air Compressor Priced Per Month. HCPCS CODE E0565.

Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Priced Per Month. E0565. Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Delivery Charge Priced Per Each. HCPCS CODE A9901.

Deliveries not made under all other line items.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Respiratory Therapist Visit Priced Per Each. HCPCS CODE VA120. Government requested Respiratory Therapist visit not covered by other Line Items.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Concentrator System.

HCPCS CODE E1392. Concentrator, Colored Tubing, Adapter Humidifier (when required), Cannulas or Masks and other required supplies and equipment, including back up systems. Perform Equipment Maintenance in accordance with manufacturer standards. At a minimum of once every 90 calendar days, visit and assess patient to assure equipment compliance, change filters and provide disposable supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable O2 Gaseous System for use with or without Stationary System Priced Per Month.

HCPCS CODE E0431. Portable System, Regulator, Flowmeter, Humidifier, Cannulas, or Masks, Tubing, Conserving Device and O2 Tank Cylinder Stands capable of holding 12 cylinders, sizes E, D, C & M-6.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Rental of Contractor Owned Stationary Liquid O2 System Priced Per Month. HCPCS CODE E0439. Reservoir, Regulator, Flowmeter, Humidifier, Cannulas or Masks, and Colored Tubing.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Portable Liquid O2 System Priced Per Month. HCPCS CODE E0434. Portable Container, Refill Adapter Flowmeter, Cannulas or Masks, and Colored Tubing. Reservoir will be provided if another Stationary System (e.g. Concentrator) is rented.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Priced Per Each. HCPCS CODE E0600.

Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Suction Pump Rental Priced Per Each. HCPCS CODE E0600. Purchase, Delivery, Set-up and Training of Contractor Home Model Respiratory Suction Pump, portable or stationary electric to include all supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Rental of Contractor Owned Volume Ventilator Priced Per Month. HCPCS CODE E0465 & E0466. Delivery, Set-up, Training, and Maintenance of Contractor Owned Stationary or Portable Ventilator, to include back up Ventilator and all supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Government Owned Ventilator Set-up Priced Per Each.

HCPCS CODE E0465 & E0466. Delivery, Set-up, and Training of a Government Owned Ventilator to include all necessary supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Ventilator Maintenance Priced Per Month. HCPCS CODE E0465 & E0466. Maintenance of Government Owned Ventilator Systems, to include all supplies.

Ordering Period: 5 POP Begin: 10-01-2030

POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Air Compressor Priced Per Month. HCPCS CODE E0565.

Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Priced Per Month. E0565. Rental of Contractor Owned and Maintained continuous or intermittent air compressor for use with equipment not self contained or cylinder driven, to include all associated supplies Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

Delivery Charge Priced Per Each. HCPCS CODE A9901.

Deliveries not made under all other line items.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Respiratory Therapist Visit Priced Per Each. HCPCS CODE VA120. Government requested Respiratory Therapist visit not covered by other Line Items.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

0001a

6,790.00 MO _______________

Rental of Contractor Owned Low Decibel Concentrator System. HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

0001b

1,320.00 MO _______________

Rental of Contractor Owned Home Fill Oxygen System.

HCPCS CODE K0738. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

0001c

6,840.00 MO _______________

Rental of Contractor Owned Hi Flow Concentrator System.

HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item

1.

Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R1

13,040.0

CY _______________

E Cylinder Refill. HCPCS CODE E0443 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R2

825.00 CY _______________

D Cylinder Refill. HCPCS CODE E0443 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R3

875.00 CY _______________

C Cylinder Refill. HCPCS CODE E0443 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R4

13,184.0

CY _______________

M-6 Cylinder Refill. HCPCS CODE E0443 Ordering Period: 1

POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R5

H Tank Refill. HCPCS CODE E0443 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

00R6

825.00 LB _______________

Liquid Oxygen Refill. HCPCS CODE E0444 Ordering Period: 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

1001a

Rental of Contractor Owned Low Decibel Concentrator System. HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

1001b

Rental of Contractor Owned Home Fill Oxygen System.

HCPCS CODE K0738. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

1001c

Rental of Contractor Owned Hi Flow Concentrator System.

HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

10R1

CY _______________

E Cylinder Refill. HCPCS CODE E0443 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

10R2

D Cylinder Refill. HCPCS CODE E0443 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

10R3

C Cylinder Refill. HCPCS CODE E0443 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

10R4

CY _______________

M-6 Cylinder Refill. HCPCS CODE E0443 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

10R5

H Tank Refill. HCPCS CODE E0443 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

10R6

Liquid Oxygen Refill. HCPCS CODE E0444 Ordering Period: 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

2001a

Rental of Contractor Owned Low Decibel Concentrator System. HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

2001b

Rental of Contractor Owned Home Fill Oxygen System.

HCPCS CODE K0738. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

2001c

Rental of Contractor Owned Hi Flow Concentrator System.

HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R1

CY _______________

E Cylinder Refill. HCPCS CODE E0443 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029

PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R2

D Cylinder Refill. HCPCS CODE E0443 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R3

C Cylinder Refill. HCPCS CODE E0443 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R4

CY _______________

M-6 Cylinder Refill. HCPCS CODE E0443 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R5

H Tank Refill. HCPCS CODE E0443 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental

PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

20R6

Liquid Oxygen Refill. HCPCS CODE E0444 Ordering Period: 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

3001a

Rental of Contractor Owned Low Decibel Concentrator System. HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

3001b

Rental of Contractor Owned Home Fill Oxygen System.

HCPCS CODE K0738. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

3001c

Rental of Contractor Owned Hi Flow Concentrator System.

HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R1

CY _______________

E Cylinder Refill. HCPCS CODE E0443 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R2

D Cylinder Refill. HCPCS CODE E0443 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R3

C Cylinder Refill. HCPCS CODE E0443 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R4

CY _______________

M-6 Cylinder Refill. HCPCS CODE E0443 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R5

H Tank Refill. HCPCS CODE E0443 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

30R6

Liquid Oxygen Refill. HCPCS CODE E0444 Ordering Period: 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

4001a

Rental of Contractor Owned Low Decibel Concentrator System. HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

4001b

Rental of Contractor Owned Home Fill Oxygen System.

HCPCS CODE K0738. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

4001c

Rental of Contractor Owned Hi Flow Concentrator System.

HCPCS CODE E1390. To include all supplies, equipment maintenance and 90 calendar day visit as described in Item 1.

Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

40R1

CY _______________

E Cylinder Refill. HCPCS CODE E0443 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

40R2

D Cylinder Refill. HCPCS CODE E0443 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

Equipment - Medical, Dental, and Veterinary Equipment and

40R3

C Cylinder Refill. HCPCS CODE E0443 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

40R4

CY _______________

M-6 Cylinder Refill. HCPCS CODE E0443 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

40R5

H Tank Refill. HCPCS CODE E0443 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of Equipment - Medical, Dental, and Veterinary Equipment and

40R6

Liquid Oxygen Refill. HCPCS CODE E0444 Ordering Period: 5 POP Begin: 10-01-2030 POP End: 09-30-2031 PRINCIPAL NAICS CODE: 532283 - Home Health Equipment Rental PRODUCT/SERVICE CODE: W065 - Lease or Rental of

GRAND TOTAL _______________

B.3 PERFORMANCE WORK STATEMENT

PERFORMANCE WORK STATEMENT - HOME OXYGEN SERVICES

SECTION 1 – SCOPE

1. Scope:

This Performance Work Statement (PWS) defines the effort required for the setup, installation, and management of Home…

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