Billing code 94016: Spirometry reviewMedicare rate & RVUs in Florida
Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service.
Medicare pays $24.74–$26.03 for 94016 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 94016 covers
This service covers a physician’s or other qualified health care professional’s review of spirometry recordings initiated by the patient, interpretation of the results, and a report. Patients typically make recordings with a spirometer outside the clinic as part of monitoring lung function over time; the clinician reviews the submitted data rather than performing a single office spirometry session. Pulmonary and primary care practices may use this service when following patients whose care includes home spirometry monitoring.
Report 94016 for the professional review and interpretation associated with a 30-day period, not for each individual recording. Documentation should identify the monitoring period, show that patient-initiated spirometry data were reviewed, and include the clinician’s interpretation and report. CMS classifies 94016 as professional-component-only; the technical portion is represented separately. When the recording service is reported under a separate technical code, keep the interpretation distinct from the equipment, recording, and data-handling work.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 94016 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$24.74 to $26.03
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $25.35 | $25.35 |
| Miami | $26.03 | $26.03 |
| Rest Of Florida | $24.74 | $24.74 |
How the 94016 rate is calculated
Each of 94016’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 94016
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.51Practice expense 0.21Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 94016
The CMS indicators that decide how 94016 is paid alongside other services.
CMS payment indicators · 94016
Spirometry review
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 2 | Professional component only. |
94016 compared with similar codes
Compare codes
94016 vs 94014 vs 94015 vs 94010: national Medicare rates
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How to choose
- 94014Remote spirometry
- 94014 covers the technical recording service. Use 94016 for the clinician’s review, interpretation, and report.
- 94015Remote spirometry
- 94015 represents the broader patient-initiated spirometry service, while 94016 is limited to professional interpretation and reporting.
- 94010Spirometry
- 94010 is for a spirometry testing session; 94016 is for clinician review of patient-initiated recordings collected during a monitoring period.
94016 billing questions
How does 94016 differ from 94014?
94016 represents professional review, interpretation, and reporting. Code 94014 represents the technical recording service.
Can 94016 be reported with 94014?
Yes, when the technical recording service and the professional interpretation are both furnished and documented for the monitoring period.
Does 94016 need modifier 26?
No modifier is needed to identify the professional component; 94016 is already a professional-component-only code.
Is 94016 reported for each home spirometry maneuver?
No. The code is for review and reporting over a 30-day period, rather than for each individual recording.
What documentation supports 94016?
Keep the monitoring period, evidence that the patient-initiated recordings were reviewed, the clinician’s interpretation, and the resulting report.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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