CMS sets reimbursement rate for wireless CV monitoring

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The Centers for Medicare & Medicaid Services (CMS) has established reimbursement rates for wireless cardiovascular telemetry.  

The reimbursement rates are applicable to the Category I CPT codes established by the American Medical Association (AMA), published Oct. 10 for Mobile Cardiovascular Telemetry. The codes and rates are contained in The Medicare Program Final Rule for the calendar year 2009 and will become effective on Jan. 1, 2009.

The 2009 national reimbursement rate for the technical component of mobile telemetry (CPT code 93229) has been carrier priced, and Highmark Medicare Services will continue to be responsible for the reimbursement rate for the new code. The current technical reimbursement rate established by Highmark Medicare Services is $1,123,  according to apress release from CardioNet, a provider of remote cardiovascular telemetry.

The new billing codes will allow for automated claims adjudication, simplifying the reimbursement process for physicians and payors, CardioNet said. Reimbursement is currently obtained through non-specific billing codes which require various narratives that, in most cases, involve semi-automated or manual processing, as well as additional review by payors.

The new Category I CPT codes, which were established by the AMA for the professional and technical components associated with  remote monitoring, are:

  • CPT code 93228: Wearable mobile cardiovascular telemetry with ECG recording, concurrent computerized real-time data analysis and greater than 24 hours of accessible ECG data storage with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; physician review and interpretation with report; and
  • CPT code 93229: Technical support for connection and patient instructions for use, attended surveillance, analysis and physician prescribed transmission of daily and emergent data reports.