$100.15–$111.16
Both describe outpatient pulmonary rehabilitation sessions. The distinguishing feature is continuous ECG monitoring, which is included in 94626.
On this page
CMS RVU26D · Effective 2026-10-01
94625 Pulmonary rehab Medicare reimbursement rates in Georgia
A physician or qualified health care professional reports this code for an outpatient pulmonary rehabilitation session conducted without continuous ECG monitoring. Compare 94625 office and facility rates across CMS payment localities in Georgia.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 94625 in Georgia?
Georgia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$79.56–$88.72
2 of 2 localities have a supported rate.
Facility setting
$16.40–$16.78
2 of 2 localities have a supported rate.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Pulmonary rehabilitation
About 94625: Outpatient pulmonary rehabilitation session
A physician or qualified health care professional reports this code for an outpatient pulmonary rehabilitation session conducted without continuous ECG monitoring.
94625 represents one outpatient pulmonary rehabilitation session delivered by a physician or other qualified health care professional without continuous ECG monitoring. These sessions are part of structured rehabilitation for people with chronic pulmonary disease, such as COPD, and may include individualized physical conditioning and disease-management education. The service is rehabilitation, not a diagnostic exercise stress test or a stand-alone inhaler demonstration.
Report one unit for the session, selecting 94625 when continuous ECG monitoring is not used; use 94626 for a session with continuous ECG monitoring. Documentation should identify the pulmonary rehabilitation session, activities provided, and monitoring approach. CMS assigns separate office and facility practice-expense inputs in the physician fee schedule, so the setting affects the fee-schedule valuation used for the service.
Where the value comes from
- Work RVU0.36 · 14%
- Practice expense (office) RVU2.20 · 84%
- Malpractice RVU0.05 · 2%
30K
Medicare services in 2024 · #976 by national volume
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.
94625 compared with similar codes
Office rates for Georgia, from the same CMS release.
$35.07–$37.65
94618 describes a simple pulmonary stress test, commonly used to assess exercise-related function. 94625 describes a rehabilitation session, not a diagnostic test.
$153.66–$168.28
94621 is cardiopulmonary exercise testing for diagnostic assessment. Choose 94625 for a pulmonary rehabilitation session without continuous ECG monitoring.
Compare 94625 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Atlanta →
Office / nonfacility
$88.72
Facility
$16.78
Rest Of Georgia →
Office / nonfacility
$79.56
Facility
$16.40
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94625 billing questions
When should 94625 be chosen over 94626?
Use 94625 for an outpatient pulmonary rehabilitation session without continuous ECG monitoring. Use 94626 when continuous ECG monitoring is part of the session.
Is 94625 reported per exercise or per session?
Report one unit for the pulmonary rehabilitation session, not a separate unit for each exercise performed during it.
Does 94625 cover a diagnostic exercise test?
No. It represents a rehabilitation session. A simple pulmonary stress test or cardiopulmonary exercise test is reported with the applicable testing code, such as 94618 or 94621.
What should the note support?
Document the outpatient pulmonary rehabilitation session, the rehabilitation activities provided, and whether continuous ECG monitoring was used.
Can inhaler instruction be reported with 94625?
94625 describes the rehabilitation session, not a separate inhaler demonstration. If inhaler instruction is provided as a distinct service, consider whether 94664 accurately describes that service and check applicable claim edits.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,40794621,,Cardiopulm exercise testing,A,,1.38,3.49,,3.49,NA,0.09,4.96,4.96,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40894621,26,Cardiopulm exercise testing,A,,1.38,0.59,,0.59,,0.06,2.03,2.03,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,40994621,TC,Cardiopulm exercise testing,A,,0.00,2.90,,2.90,NA,0.03,2.93,2.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
12,41094625,,Phy/qhp op pulm rhb w/o mntr,A,,0.36,2.20,,0.08,,0.05,2.61,0.49,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,41194626,,Phy/qhp op pulm rhb w/mntr,A,,0.56,2.64,,0.10,,0.07,3.27,0.73,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,41294640,,Airway inhalation treatment,A,,0.00,0.25,,0.25,NA,0.01,0.26,0.26,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,41394642,,Aerosol inhalation treatment,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00