CPT 94619 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 | Pulmonary Diagnostic Testing and Therapies Pulmonary Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 25 - Significant, separately identifiable E/M service same day |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 94619 |
National average reimbursement for CPT 94619 by major payers:
$84.46
$98.40
$89.56
$122.27
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 94619 | $180.63 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $76.76 | 1679739395 - BETSY OSTRANDER | 942854057 - IHC HEALTH SERVICES INC | UT | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $114.48 | 1881012235 - LAUREN PREST | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $39.49 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $536.29 | 1760502058 - P. DANIEL LE GRANGE | 943281657 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $122.37 | 1679968697 - JEREMIAH BREWER | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 94619 | $141.33 | 1932130325 - ELIZABETH BERRY-KRAVIS | 911780160 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $61.47 | 1437438249 - KAPIL AEDMA | 370661223 - METHODIST MEDICAL CENTER OF ILLINOIS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94619 | $79.80 | 1205125473 - KELLEY VOLPE | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $92.87 | 1760412621 - RHONDA LAMPEN | 911352172 - MULTICARE HEALTH SYSTEM | VA | Psychiatry Physician (2084P0800X) |
United | 94619 | $69.16 | 1265883375 - JOCELYN LORENZO | 726000821 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $88.48 | 1992961643 - CYNTHIA GORDON | 815174138 - (IL) ILLINOIS PROFESSIONALS HEALTH PROGR | IL | Psychiatry Physician (2084P0800X) |
United | 94619 | $100.29 | 1366890857 - STEVEN SHARP | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 94619 | $160.44 | 1386755486 - DOUGLAS NORDLI | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 94619 | $125.12 | 1205213261 - TAMAR CACERES | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurodevelopmental Disabilities Physician (2084P0005X) |
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 94619 vs. Other Pulmonary Procedures Codes
The CPT 94619 code is part of the Pulmonary Diagnostic Testing and Therapies 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 94619 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 |
|---|---|---|
| 94012-CPT | Low | Breathing Test With Medication, Test To See How Well A Medication For Increasing Airflow To The Lungs (Bronchodilator) Works. The Person Breathes Into A Spirometer (Device For Measuring Airflow) Before Using The Medicine And Then Afterward. |
| 94013-CPT | Low | Lung Function Test, A Lung Function Test Evaluates Breathing Ability. Measures Include The Amount Of Air Entering Or Leaving The Body The Amount Of Oxygen Circulating To Organs And The Amount Of Air Left In The Lungs After Exhaling. |
| 94617-CPT | Low | Exercise Test For Bronchospasm, Exercise Test For Bronchospasm Including Pre- Andpost-Spirometry Electrocardiographic Recording(S ) And Pulse Oximetry Age Adjustment (As Needed) And Scheduling Of Additional Test(S) When Performed |
| 94619-CPT | Low | Exercise Test For Bronchospasm, The Test Measures The Amount Of Air That Moves In And Out Of The Lungs During Breathing. Exercise Is Introduced To See If A Bronchospasm (Asthma Attack) Occurs. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94619. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94619 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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