As discussed elsewhere, when CMS established G0424 to bill for pulmonary rehabilitation, it combined into a single code several services that had been paid separately prior to national implementation. This change continues to cause confusion among hospitals as they struggle to determine the appropriate charge to submit on their claims, resulting in lower-than-expected payment rates. AARC together with all clinical societies integral to the delivery of pulmonary rehab designed a toolkit to educate and assist hospitals in setting the charge for G0424. The information provided is designed to ensure that hospitals carefully consider all the services, supplies and equipment that are integral to the provision of pulmonary rehabilitation services encompassed in G0424 and establish appropriate charges reflective of that scope of services when they submit a claim to Medicare for payment.
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