On this page

CMS RVU26D · Effective 2026-10-01

94016 Spirometry review Medicare reimbursement rates in Maine

Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service. Compare 94016 office and facility rates across CMS payment localities in Maine.

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 94016 in Maine?

Maine 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

$23.90–$24.41

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $0.51 per service.

Facility setting

$23.90–$24.41

2 of 2 localities have a supported rate.

Lowest: Rest Of Maine

Highest: Southern Maine

A spread of $0.51 per service.

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.

Find 94016 in your payment locality →

Pulmonary function testing

About 94016: Patient-recorded spirometry interpretation

Reports a clinician’s interpretation of patient-initiated spirometry recordings collected during a 30-day monitoring period, separate from the technical service.

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.

CMS billing rules for 94016

Professional and technical components
Professional-component-only code: interpretation and report; a separate code covers the technical portion.

Where the value comes from

  • Work RVU0.51 · 69%
  • Practice expense (office) RVU0.21 · 28%
  • Malpractice RVU0.02 · 3%

6.8K

Medicare services in 2024 · #1676 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.

94016 compared with similar codes

Office rates for Maine, from the same CMS release.

94014

Remote spirometry

30-day recording

$56.07–$59.04

94014 covers the technical recording service. Use 94016 for the clinician’s review, interpretation, and report.

94015

Remote spirometry

Technical recording component

$32.17–$34.64

94015 represents the broader patient-initiated spirometry service, while 94016 is limited to professional interpretation and reporting.

94010

Spirometry

No post-bronchodilator comparison

$27.60–$29.27

94010 is for a spirometry testing session; 94016 is for clinician review of patient-initiated recordings collected during a monitoring period.

Compare 94016 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

Office and facility base rates · shared scale starting at $0

Need rates for a whole code list?

Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.

Explore fee-sheet early access →

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 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.

RVUs for 94016PPRRVU2026_Oct_nonQPP.csv, line 12,372 (RVU26D)