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2009 Diagnostic Testing Reimbursement
For your convenience, here is a summary of commonly performed Diagnostic tests.
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CPT CODE DESCRIPTION 2009 MPFS AMOUNT CPT CODE DESCRIPTION 2009 MPFS AMOUNT
    CARDIAC REHAB    
93000 Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report
93797 Physician services for outpatient cardiac rehabilitation; without continuous ECG monitoring (per session)
93005 Tracing only, without interpretation and report
93798 Physician services for outpatient cardiac rehabilitation; with continuous ECG monitoring (per session)
93010 Interpretation and report only
     
93040 Rhythm ECG, one to three leads, with report
   
93041 Tracing only, without interpretation and report
94010 Spirometry, including graphic record, total and timed vital capacity, expiratory flow rate measurement(s), with or without maximal voluntary ventilation
93042 Interpretation and report only
94010-TC technical component
      94010-26 professional component
    94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post-bronchodilator administration
93015 Cardiovascular Stress Test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and /or pharmacological stress with physician supervision, interpretation and report
94060-TC technical component
93016 Physician supervision only, without interpretation and report
94060-26 professional component
93017 tracing only, without interpretation and report
94070 Bronchospasm provocation evaluation, multiple spirometric determinations as in 94010, with administered agents (eg, antigen[s], cold air, methacholine)
93018 Interpretation and report only
94070-TC technical component
      94070-26 professional component
T-WAVE ALTERNANS     94150 Vital capacity, total (separate procedure) - BUNDLED PROCEDURE - NOT SEPARATELY PAID BY MEDICARE BUNDLED
93025 Microvolt T-wave Alternans Testing - Microvolt T-wave alternans for assessment of ventricular arrhythmias
94150-TC technical component BUNDLED
93025-TC technical component
94150-26 professional component BUNDLED
93025-26 professional component
94200 Maximum breathing capacity, maximal voluntary ventilation
      94200-TC technical component
      94200-26 professional component
      94375 Respiratory flow volume loop
    94375-TC technical component
93230 Holter Testing - Electorcardiographic monitoring for 24 hours by continuous original ECG waveform recording and storage without visual superimposition scanning.
94375-26 professional component
93231 Recording (includes hook-up, recording and disconnection)
94664 Demonstration and/or evaluation of patient utilization of an aerosol generator, nebulizer, metered dose inhaler or IPPB device
93232 Microprocessor-based analysis with report
   
93233 Physician review and interpretation
94760 Noninvasive ear or pulse oximetry for oxygen saturation; single determination
      94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple determinations (eg, during exercise)
    94762 Noninvasive ear or pulse oximetry for oxygen saturation; by continuous overnight monitoring (separate procedure)
93784 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; including recording, scanning analysis, interpretation and report
STRESS ECHO    
93786 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; recording only
93350 Echocardiography, transthoracic, real-time with image documentation (2D), with or without M-mode recording, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report
93788 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; scanning analysis with report
93350-TC technical component
93790 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape and/or computer disk, for 24 hours or longer; physician review with interpretation and report
93350-26 professional component

EQUIPMENT DIAGNOSTIC DATA IS ESTIMATED REIMBURSEMENT INFORMATION USED AS A GUIDE ONLY. THIS WORKSHEET IS FOR DISCUSSION/FINANCIAL ANALYSIS PURPOSES ONLY, SPECIFICALLY TO REPORT MEDICARE PAYMENT LEVELS FOR CPT CODES RELATED TO VARIOUS DIAGNOSTIC SERVICES. THIS ANALYSIS IS DEPENDENT ON INFORMATION PROVIDED BY THE PROVIDER. IT DOES NOT INCLUDE ALL PRACTICE COSTS AND THEREFORE DOES NOT ESTIMATE PROFITABILITY. THIS IS NOT A GUARANTEE OF EARNINGS LEVELS, NOR IS IT INTENDED TO MAKE RECOMMENDATIONS REGARDING CLINICAL PRACTICE. IT IS THE RESPONSIBILITY OF THE PROVIDER TO DETERMINE APPROPRIATE CODING AND FOLLOW LOCAL CARRIER COVERAGE AND CODING POLICIES. THE PAYMENT AMOUNTS INDICATED ARE BASED UPON DATA ELEMENTS PUBLISHED IN THE NOVEMBER 19, 2008 FEDERAL REGISTER. CMS MAY MAKE ADJUSTMENTS TO ANY OR ALL OF THE DATA INPUTS FROM TIME TO TIME.  ALL CPT CODES ARE COPYRIGHT AMA