LCDActive
Respiratory Care
L34149
Effective: October 16, 2025
Updated: December 31, 2025
Policy Summary
Respiratory care services and pulmonary function testing are covered when ordered by a treating physician or NPP and are medically necessary for assessment, diagnosis, treatment, management, or monitoring of documented cardiopulmonary disease. Medicare excludes routine screening tests, repetitive/unnecessary batteries of tests, and non-individualized group education; repeat testing is allowed only with documented clinically significant change and required personnel/facility qualifications and documentation must be maintained.
Coverage Criteria Preview
Key requirements from the full policy
"Respiratory care services are covered when prescribed by a physician or non-physician practitioner for assessment, diagnostic evaluation, treatment, management, or monitoring of documented cardiopu..."
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