$85.44–$101.09
Choose 94626 when the pulmonary rehabilitation session includes continuous oximetry; 94625 describes the session without that monitoring.
On this page
CMS RVU26D · Effective 2026-10-01
94626 Pulmonary rehab Medicare reimbursement rates in Virginia
Report this service for an outpatient pulmonary rehabilitation session delivered by a physician or qualified health care professional with continuous oximetry monitoring. Compare 94626 office and facility rates across CMS payment localities in Virginia.
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 94626 in Virginia?
Virginia 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
$107.03–$126.19
2 of 2 localities have a supported rate.
Facility setting
$23.64–$26.25
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 94626: Outpatient pulmonary rehabilitation with oximetry
Report this service for an outpatient pulmonary rehabilitation session delivered by a physician or qualified health care professional with continuous oximetry monitoring.
This service covers a session of outpatient pulmonary rehabilitation that includes continuous oximetry monitoring. It is used for patients with chronic respiratory disease who need structured rehabilitation, commonly people with COPD working to improve exercise tolerance and manage breathlessness. A physician or other qualified health care professional provides the service; rehabilitation staff may support exercise and other session activities. The oximetry monitors oxygen saturation continuously during the session, rather than only at selected points.
Report one unit for the rehabilitation session, not for each exercise or monitoring interval. Documentation should identify the patient’s pulmonary rehabilitation session, the services performed, and the continuous oximetry monitoring. Code 94625 is the sibling option when the session is performed without continuous oximetry. Continuous monitoring distinguishes 94626 from that code; it is not an additional service to report separately from the session code.
Where the value comes from
- Work RVU0.56 · 17%
- Practice expense (office) RVU2.64 · 81%
- Malpractice RVU0.07 · 2%
48.8K
Medicare services in 2024 · #787 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.
94626 compared with similar codes
Office rates for Virginia, from the same CMS release.
$36.43–$41.66
94618 reports pulmonary stress testing to assess exercise response. It is not a session of ongoing outpatient pulmonary rehabilitation.
$162.80–$189.25
94621 is cardiopulmonary exercise testing, a diagnostic assessment of exercise capacity; 94626 is a pulmonary rehabilitation session with continuous oximetry.
Compare 94626 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
Dc + Md/Va Suburbs →
Office / nonfacility
$126.19
Facility
$26.25
Virginia →
Office / nonfacility
$107.03
Facility
$23.64
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94626 billing questions
How does 94626 differ from 94625?
94626 is for an outpatient pulmonary rehabilitation session with continuous oximetry. Use 94625 when the session does not include continuous oximetry.
Is the code reported per session or per exercise?
Report one unit for the rehabilitation session. Do not count individual exercises or monitoring intervals as separate units.
Can continuous oximetry be billed separately from 94626?
Continuous oximetry is the distinguishing element of 94626, not a separate add-on service to report for that session.
What documentation supports reporting 94626?
Document the outpatient pulmonary rehabilitation session, the services performed, and continuous oximetry monitoring during the session.
Is 94626 a pulmonary exercise stress test?
No. It reports a rehabilitation session. Codes such as 94618 describe pulmonary stress testing to assess exercise response, not a rehabilitation session.
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.
12,40894621,26,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
12,41494644,,Cont inhlj tx 1st hour,A,,0.00,1.85,,1.85,NA,0.02,1.87,1.87,5,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00