Respiratory Therapy Billing Services

Respiratory therapy billing is unusual because respiratory therapists themselves are often not the billing provider. Their work is usually billed by a hospital, a physician practice, a home care company, or a pulmonary program. That means the claim format and the rules depend on where the service happens.

Testing, breathing treatments, and oxygen monitoring each have separate codes, and many are limited by frequency or by a supervising provider requirement. Westmont connects respiratory care departments, pulmonary clinics, and home care providers with vetted billing experts who understand how these services are billed in each setting. Respiratory therapy billing improves when billers know both the codes and the payer rules behind them.

Who this is for

• Hospital respiratory care departments
• Pulmonology practices that employ respiratory therapists
• Pulmonary function labs
• Home respiratory and oxygen providers
• Sleep and ventilator programs
• Skilled nursing facilities with respiratory services
• Asthma and COPD education programs

What gets billed

• Spirometry and pulmonary function tests
• Responses to bronchodilator medicine
• Breathing treatments with nebulized medicine
• Training on inhalers and nebulizers
• Pulse oximetry, single, repeated, and overnight
• Walk tests that measure oxygen levels
• Chest wall airway clearance
• Ventilator management
• Pulmonary rehabilitation sessions
• Oxygen and respiratory equipment, billed by the supplier

Commonly billed codes

Code	Type	What it covers
94010	CPT	Spirometry, breathing test measuring airflow and volume
94060	CPT	Spirometry before and after a bronchodilator
94640	CPT	Breathing treatment with inhaled medicine
94664	CPT	Demonstration and review of how a patient uses an inhaler or nebulizer
94618	CPT	Exercise test for lung function, such as a walk test, with a report
94760	CPT	Pulse oximetry, single reading
94761	CPT	Pulse oximetry, multiple readings
94762	CPT	Pulse oximetry, continuous overnight monitoring
94667	CPT	Chest wall manipulation to clear airways, first session
94726	CPT	Body plethysmography, a lung volume test
J44.9	ICD-10-CM	Chronic obstructive pulmonary disease, unspecified
J45.909	ICD-10-CM	Asthma, unspecified, uncomplicated

Note

Codes are examples for orientation, not a complete list, and do not guarantee coverage or payment. Always check current code sets and payer policy.

Billing challenges in respiratory therapy

Who is the billing provider. Respiratory therapists generally cannot enroll with Medicare as independent billers. Services are billed under a facility, physician, or supplier. Billers confirm the correct entity and supervision rules for each site.

Bundled services. Pulse oximetry is often bundled with an office visit or another service on the same day. Billers learn each payer's bundling edits so they do not bill what will deny.

Frequency limits. Payers limit how often breathing treatments, spirometry, and oximetry are paid. Billers track dates and diagnoses against the policy.

Diagnosis support. Medical necessity rests on a documented respiratory condition and a clear order. Billers check that the diagnosis supports each test or treatment.

Facility versus professional claims. In hospitals, the technical and professional parts are billed separately and sometimes on different forms. Billers keep them straight.

Home respiratory equipment. Oxygen, ventilators, and related supplies follow durable medical equipment rules with face-to-face and testing requirements. Billers collect the paperwork or send it to the equipment billing team.

Pulmonary rehab. These sessions use their own codes and Medicare requirements, so billers keep that program's claims separate from general respiratory services.

How Westmont can help

• Matching your department or practice with vetted billing experts experienced in respiratory therapy billing
• End-to-end revenue cycle support, from verification to payment posting
• Denial management for medical necessity, bundling, and frequency edits
• Credentialing and enrollment help where it applies
• Support aligning facility and professional billing workflows

Frequently asked questions

Can respiratory therapists bill insurance directly?

In most settings, no. Respiratory therapists are generally not independently recognized by Medicare as billing providers, so their services are billed by a hospital, physician practice, or supplier. Some states and commercial plans differ, so check the rules for your setting and payer.

What are common respiratory therapy CPT codes?

Common codes cover spirometry, bronchodilator response testing, inhaled treatments, inhaler training, and pulse oximetry. Which ones apply depends on the setting and what was done. Always verify against current code sets and payer policy, since bundling and frequency limits are common.

Why is pulse oximetry often denied?

Many payers treat pulse oximetry as part of an office or hospital visit, so a separate payment is denied unless a specific policy allows it. Overnight oximetry is different and usually needs medical necessity and an order. Billers check policy before submitting.

How does home oxygen billing differ from clinic billing?

Home oxygen is usually billed as durable medical equipment by a supplier, with testing results, a physician order, and rules about when the equipment is covered. Clinic services are billed as procedures. Both need clean documentation, but the forms and rules differ.

Do you help with hospital respiratory care departments?

Yes, in the sense that Westmont can match hospitals with billing experts who understand facility billing. Tell us how your charges are captured and which systems you use, and we will look for experts with matching experience.

Related billing services

• Pulmonology
• Cardiac & Pulmonary Rehab
• Sleep Medicine
• Durable Medical Equipment
• Home Health Agencies
• Critical Care