How the monthly billing is built
- Each RT order from the eMAR is classified into a therapy type and matched to its CPT code
- Administration records confirm which days therapy was given
- Only days the resident was present and Part B eligible are counted
- Dates of service are chosen to follow the coding rules, for example billing 94010 and 94060 on separate dates
- A validation pass checks the totals before anything is submitted
Codes we commonly bill
- 94010: spirometry
- 94060: bronchodilation responsiveness (pre- and post-bronchodilator spirometry)
- 94667–94669: chest wall manipulation
- 94760 / 94761: pulse oximetry (requires a qualifying pulse-ox diagnosis)
- G0237: therapeutic procedures to increase strength or endurance of respiratory muscles
Frequently asked questions
Can a nursing home bill Medicare Part B for respiratory therapy?
Yes. For residents who are not in a covered Part A stay and meet Part B eligibility and diagnosis requirements, the SNF can bill Part B respiratory therapy services under its own NPI.
Do pulse oximetry codes need a specific diagnosis?
Yes. Pulse oximetry (94760, 94761) needs a qualifying pulse-ox diagnosis on the resident’s record. CareComply checks this daily and flags orders that would not be billable.
Sources
- CMS Medicare Claims Processing Manual, Pub. 100-04, Chapter 7 (SNF Part B billing)
- 42 CFR §424.44: time limits for filing claims
- CMS: Skilled Nursing Facility Consolidated Billing
Review status: Pending compliance review