Prior Auth Required

94625 - Pulmonary Rehabilitation – Referral Required

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / ServicePulmonary Rehabilitation – Referral Required
Procedure / Service Description

When billing for these services, please use the following codes - When billing for these services, please use the following codes: Cardiac Rehabilitation – Referral Required: 93797, 93798 Pulmonary Rehabilitation – Referral Required: 94625, 94626 For additional information, please see Policy 404-1720 – Private Duty Nursing EPSDT Benefit and Policy 404- 1729 – Pulmonary Rehabilitation Services.

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.