Question:

Do any special billing requirements exist related to new 2022 codes 94625 and 94626?

Answer:

In the hospital outpatient setting, payment for PR services will be set by establishing a clinical APC with a median โ€œper-sessionโ€ cost, simulated from historical claims data for similar pulmonary therapy services. Physical therapists cannot bill PT codes separately if they conduct assessments and individual treatment services as part of a PR program. The PT services are now included as part of the overall treatment plan for PR and are to be billed using the new codes 94625โ€“94626 for 2022.

This question was answered in our Coding Essentials for RT/Pulmonary Function. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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