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US · guidance

CMS Pub. 100-04, ch. 19, § 100.11.2

A/B MAC (A) – Pulmonary Rehabilitation Services - Claims

activein force · 2026-08-25 – presentas-observed

Processing

(Rev. 3897, Issued: 10-27-17, Effective: 01-01-10, Implementation: 04-02-18)

Pulmonary Rehabilitation services are reported on TOB 13X or 85X using revenue code

948 and HCPCS code G0424.

No clinic visit shall be billed if a pulmonary rehabilitation service is the only service

received. These services may be billed with or without a clinic visit.

The MSN is suppressed.

Note: See Medicare Claims Processing Manual, Chapter 32 – Billing Requirements for

Special Services, Section 140.4 for additional billing instructions, frequency editing and

limitations.

History

(Rev. 3897, Issued: 10-27-17, Effective: 01-01-10, Implementation: 04-02-18)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
a7d54b9c8c8be87de1efb7c4919bc0234278f6b07e54866b3468e64e1e535e74
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