Professional services for outpatient pulmonary rehabilitation, per session
Medicare pricing data for 207 providers across 18 states
Prices vary significantly by location — from $16 in Alabama to $68 in New Jersey. 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, per session (HCPCS code 94625) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $62.15, but hospitals typically charge $115.23 — a 1.9x 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 $62.15, your out-of-pocket cost would be approximately $12.43. 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 1.9x more than what Medicare allows for this procedure. Medicare actually pays $49.01 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| New Jersey | $68 | $165 | 2 | 459 | +9.0% |
| New York | $68 | $286 | 15 | 1,375 | +9.0% |
| Texas | $65 | $127 | 14 | 13,807 | +4.2% |
| Illinois | $64 | $142 | 12 | 691 | +3.5% |
| California | $63 | $585 | 12 | 463 | +1.4% |
| Maryland | $62 | $80 | 2 | 24,577 | +0.1% |
| Colorado | $60 | $138 | 16 | 159 | -2.8% |
| Pennsylvania | $58 | $204 | 14 | 586 | -5.9% |
| Florida | $57 | $226 | 16 | 1,101 | -8.3% |
| Wisconsin | $56 | $170 | 11 | 69 | -9.5% |
| Georgia | $56 | $152 | 9 | 625 | -9.6% |
| North Carolina | $56 | $210 | 2 | 51 | -10.5% |
| New Mexico | $54 | $62 | 2 | 643 | -13.8% |
| Arizona | $53 | $217 | 11 | 350 | -14.2% |
| Indiana | $53 | $111 | 18 | 1,045 | -15.1% |
| Arkansas | $51 | $100 | 1 | 387 | -17.4% |
| Ohio | $17 | $65 | 2 | 78 | -72.6% |
| Alabama | $16 | $99 | 2 | 86 | -74.0% |
⚠️ 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