Respiratory Question for the Week of June 17, 2019

Question:

What does Medicare require for pulmonary rehabilitation patient coverage?

Answer:

Medicare requires that a patient meet the chronic obstructive pulmonary disease (COPD) GOLD stages II–IV criteria to be eligible for Medicare coverage of pulmonary rehabilitation as described by HCPCS level II code G0424.

G0424

Pulmonary rehabilitation, including exercise (includes monitoring) one hour, per session, up to two sessions per day

This question was answered in our annual Respiratory Therapy Reimbursement & Compliance Update webcast. For more hot topics relating to respiratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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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Respiratory Question for the Week of June 17, 2019

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