Question:

Can ventilator management codes be paid in addition to an E&M visit code?

Answer:

 Medicare has a specific payment policy for ventilator management codes (94002–94004, 94660, and 94662). Under the Medicare Part B Physician Fee Schedule, ventilator management services may not be paid in addition to an evaluation and management (E&M) visit code even when the E&M code is billed with a modifier. This is applicable to all ED E&M visit codes and critical-care codes.

 

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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.

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