Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session
Medicare pricing data for 113 providers across 12 states
Prices vary significantly by location — from $26 in Massachusetts to $89 in New York. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Professional services for outpatient pulmonary rehabilitation with continuous monitoring of blood oxygen, per session (HCPCS code 94626) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $83.15, but hospitals typically charge $248.79 — a 3.0x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $83.15, your out-of-pocket cost would be approximately $16.63. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.0x more than what Medicare allows for this procedure. Medicare actually pays $66.00 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New York | $89 | $329 | 18 | 3,250 | +7.1% |
| Illinois | $88 | $159 | 7 | 1,943 | +6.2% |
| Texas | $86 | $154 | 7 | 5,897 | +3.3% |
| California | $84 | $506 | 11 | 2,141 | +1.0% |
| Ohio | $79 | $567 | 1 | 475 | -5.0% |
| New Hampshire | $79 | $80 | 1 | 153 | -5.5% |
| Washington | $77 | $120 | 2 | 484 | -7.1% |
| Maryland | $77 | $210 | 7 | 519 | -7.6% |
| Nevada | $77 | $177 | 5 | 418 | -7.7% |
| West Virginia | $69 | $111 | 4 | 133 | -16.7% |
| Pennsylvania | $26 | $124 | 3 | 120 | -68.5% |
| Massachusetts | $26 | $125 | 1 | 63 | -68.6% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber