Respiratory Therapy and Oximetry Services

Respiratory therapy services are generally facility responsibilities; physician payment is allowed only when services are integral to the physician's professional care or when personally performed/supervised by the physician or qualified NPP. Pulse oximetry is covered for acute respiratory dysfunction signs/symptoms, certain chronic or severe cardiopulmonary or neuromuscular respiratory diseases for specified reasons (initial evaluation, acute change, exercise tolerance, or oxygen-therapy determination), trauma/chest pain, and monitoring of medications with pulmonary toxicity. Tests by DME suppliers to qualify patients for home oxygen are explicitly not covered.

"Respiratory therapy services are covered when rendered as an integral and incidental part of a physician's professional services during diagnosis or treatment of an injury or illness."

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