Oximeter Guidelines for Reimbursement

Noninvasive pulse oximetry is used to estimate the arterial oxygen saturation of a patient. It is typically covered under three different codes, 94760, 94761 and 94762, by Medicare. These rates do not necessarily apply to other insurance coverage.

94760

• Code 94760 is for a simple pulse oximetry study with a single value documented or a one time reading. The 2009 Medicare relative value unit (RVU) is .08, which means an allowable, geographically unadjusted rate of $2.89. Geographical adjustments are set by Medicare based on the estimated operating expenses in different areas of the United States.

94761

• Code 94761 covers ear or pulse oximetries for multiple determinations during various activities, such as exercise, standing and sitting. The 2009 RVU for this is 0.16 or a geographically unadjusted $5.77.

94762

• Code 94762 covers overnight oximetry monitoring. The RVU is 0.82, which means a geographically unadjusted reimbursement rate of $29.57.