Respiratory Question for the Week of March 13, 2017

Question:

Are the CPT codes for patient-initiated spirometric recording covered by Medicare and/or private payers?

Answer:

Generally, Medicare does not cover CPT codes 94014, 94015, and 94016 since, according to the Centers for Medicare & Medicaid Services (CMS), the clinical efficacy of the procedure has not been established. However, the have assigned 94014 and 94015 to APCs. Many states have coverage policies for patient-initiated spirometric recording, so be sure to check with the Medicare payer for coverage polices relevant to your facility.