CPT 94002 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Pulmonary Procedures |
| Common Place of Service | • 21 - Inpatient Hospital • 42 - Ambulance - Air or Water |
| Common Modifiers | • None • 59 - Distinct Procedural Service • XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
National average reimbursement for CPT 94002 by major payers:
$124.17
$117.51
$120.08
$155.53
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 94002 | ||||||
United | 94002 | $168.85 | 1508984907 - DAVID BERRIER | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 94002 | $164.17 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94002 | $187.42 | 1386800662 - NICHOLAS HATZIS | 364187449 | IL | Psychiatry Physician (2084P0800X) |
United | 94002 | $158.38 | 1184815870 - RYAN COATES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94002 | $174.91 | 1669598421 - CHANDRIKA SHANKAR | 911780160 | NY | Psychiatry Physician (2084P0800X) |
United | 94002 | $162.47 | 1952569758 - CHARLES HEBERT | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 94002 | $87.59 | 1962507954 - ROSELIN ARUNACHALAM | 371140016 - CARLE HEALTH CARE INCORPORATED | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94002 | $259.80 | 1740252972 - DAVID HSU | 390817529 - ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS | WI | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94002 | $183.05 | 1245252303 - MARY FAHRMEIER | 910844563 | VA | Psychiatry Physician (2084P0800X) |
United | 94002 | $145.50 | 1972063501 - PALOMA REINOSO | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94002 | $174.91 | 1144203753 - HAIDAR KABBANI | 911780160 | OH | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94002 | $78.34 | 1255692794 - MELISSA WAGNER-SCHUMAN | 316000064 | IL | Psychiatry Physician (2084P0800X) |
United | 94002 | $158.38 | 1992905335 - PARAG MERAI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94002 | $202.30 | 1043252521 - DENIS ALTMAN | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | MO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94002 | $162.47 | 1972984169 - DAVID SHOLTES | 362174823 - (IL) RUSH UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 94002 vs. Other Pulmonary Procedures Codes
The CPT 94002 code is part of the Medicine Services and Procedures services used for Pulmonary Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 94002 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 94002-CPT | Low | Ventilation Assist And Management, Initiation Of Pressure Or Volume Preset Ventilators For Assisted Or Controlled Breathing; Hospital Inpatient/Observation, Initial Day |
| 94003-CPT | Low | Ventilation Assist And Management, Initiation Of Pressure Or Volume Preset Ventilators For Assisted Or Controlled Breathing; Hospital Inpatient/Observation, Each Subsequent Day |
| 94004-CPT | Low | Ventilation Assist And Management, Initiation Of Pressure Or Volume Preset Ventilators For Assisted Or Controlled Breathing; Nursing Facility, Per Day |
| 94010-CPT | Low | Spirometry, Including Graphic Record, Total And Timed Vital Capacity, Expiratory Flow Rate Measurement(S), With Or Without Maximal Voluntary Ventilation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94002. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94002 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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