CPT 94774 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 | • 19 - Off Campus Outpatient Hospital • 99 - Other POS |
| Common Modifiers | • None |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 94774 |
National average reimbursement for CPT 94774 by major payers:
$394.02
$402.20
$309.73
$479.81
| 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 94774 | ||||||
United | 94774 | $368.07 | 1275564197 - PAUL BERKOWITZ | 842494027 - BRIGHTSIDE MEDICAL | FL | Psychiatry Physician (2084P0800X) |
United | 94774 | $301.26 | 1316237530 - MATHERS CLINIC LLC, MATHERS CLINIC | 300626803 - (IL) MATHERS CLINIC LLC | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $400.89 | 1043522899 - SHARAD KOIRALA | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 94774 | $253.69 | 1578767935 - FABIAN CARBONELL MD SC | 364336222 - (IL) FABIAN CARBONELL MD SC | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $768.38 | 1205213261 - TAMAR CACERES | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurodevelopmental Disabilities Physician (2084P0005X) |
United | 94774 | $239.83 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $509.63 | 1952387318 - MELANY DANEHY | 911780074 | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $350.77 | 1245360411 - ANDREW KULIK | 364340137 - (IL) SAINT ANTHONY HEALTH AFFILIATES | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $306.67 | 1285350918 - ERIN KELLY | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Occupational Therapist (225X00000X) |
United | 94774 | $529.60 | 1295792265 - MARIE TOBIN | 362177139 - UNIVERSITY OF CHICAGO | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $475.00 | 1548279870 - VINOD ALLURI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | TX | Psychiatry Physician (2084P0800X) |
United | 94774 | $572.85 | 1114196995 - ANGELA GREEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $451.83 | 1942330576 - NASIR SYED | 862358048 - (IL) INSIGHT CHICAGO INC | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $617.95 | 1356397210 - M SHEIKH | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 94774 | $575.58 | 1962664789 - JAMIE EVANS | 910844563 | WI | 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 94774 vs. Other Pulmonary Procedures Codes
The CPT 94774 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 94774 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 |
|---|---|---|
| 94772-CPT | Moderate | Circadian Respiratory Pattern Recording (Pediatric Pneumogram), 12 To 24 Hour Continuous Recording, Infant |
| 94774-CPT | Moderate | Pediatric Home Apnea Monitoring Event Recording Including Respiratory Rate Pattern And Heart Rate Per 30-Day Period Of Time; Includes Monitor Attachment Download Of Data Review Interpretation And Preparation Of A Report By A Physician Or Other Qualified Health Care Professional (Revised 01/01/13) |
| 94775-CPT | Low | Pediatric Home Apnea Monitoring Event Recording Including Respiratory Rate, Pattern And Heart Rate Per 30-Day Period Of Time; Monitor Attachment Only (Includes Hook-Up, Initiation Of Recording And Disconnection) |
| 94776-CPT | Moderate | Pediatric Home Apnea Monitoring Event Recording Including Respiratory Rate, Pattern And Heart Rate Per 30-Day Period Of Time; Monitoring, Download Of Information, Receipt Of Transmission(S) And Analyses By Computer Only |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 94774. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 94774 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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