CPT 93245Cardiology

Ext ecg>7d<15d rec scan a/r

CPT code 93245 covers the professional service of scanning and analyzing heart rhythm recordings from a wearable monitor worn for 7 to 15 days. This includes the physician's review of the recorded data and preparation of a comprehensive report on heart rhythm abnormalities.

Showing rates for

National Average

Base Medicare rate

$270.42

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.55

PE RVU (NF)

7.77

MP RVU

0.04

Total RVU

8.36

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Bill 93245 only once per monitoring period regardless of the number of days between 7-15; this represents the complete professional interpretation service
Impact: Prevents duplicate billing denials and potential fraud allegations; ensures compliant billing practice
Ensure monitoring duration is documented as exceeding 7 days but not reaching 15 days; if monitoring is 15 days or longer, use CPT 93247 instead ($379.16 Medicare rate)
Impact: Using wrong code for duration leaves $108.74 on table (difference between 93247 and 93245)
Do not bill 93245 with 93244 when performed by same provider in same practice on same date; 93244 is technical component, 93245 is professional, but ensure split billing is contractually allowed
Impact: Combined appropriate billing yields $270.42 (professional) plus technical component payment when properly split
Verify patient symptom diary was completed and correlated with ECG findings in your interpretation; documentation must show symptom-rhythm correlation analysis
Impact: Missing symptom correlation is primary audit trigger resulting in up to 100% payment recoupment ($270.42 at risk)
Bill on the date the final interpretation report is signed and completed, not the date monitoring ended; this is when professional work is finalized
Impact: Prevents timely filing denials and ensures accurate date of service reporting
For Medicare patients, verify that the extended monitoring was ordered due to medical necessity (failed shorter-duration monitoring or clinical indication requiring extended observation)
LCD/NCD compliance prevents medical necessity denials; average appeal costs $150-300 per claim

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 93245?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 93245 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 93245 is $270.42 for both facility and non-facility settings. This rate is based on 8.36 total RVUs (0.55 work RVU, 7.77 PE RVU, 0.04 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 93245 and 93244?

CPT 93244 is the technical component (equipment, hookup, recording, supplies) while CPT 93245 is the professional component (physician scanning, analysis, and report). Code 93244 is billed by the facility or supplier providing the monitoring equipment, while 93245 is billed by the interpreting physician. Both cover the same 7-15 day duration range.

How many days of monitoring are required for CPT 93245?

CPT 93245 requires more than 7 days but less than 15 days of continuous external ECG recording. If monitoring is 7 days or less, use codes 93224-93227. If monitoring is 15 days or longer, use codes 93247-93248 instead.

Can I bill CPT 93245 more than once during the same monitoring period?

No, CPT 93245 should be billed only once per monitoring period as it represents the complete professional interpretation of the entire 7-15 day recording. Billing multiple times for the same monitoring session constitutes duplicate billing and will result in denials.

What documentation is required to support billing CPT 93245?

Required documentation includes: monitoring start/stop dates proving 7-15 day duration, complete rhythm analysis, quantification of all arrhythmias, heart rate ranges, symptom-rhythm correlation using patient diary, clinical interpretation of findings, and physician signature with credentials. Missing any element increases audit risk significantly.

Does CPT 93245 include both the professional and technical components?

No, CPT 93245 is the professional component only, representing physician work for scanning, analyzing, and reporting. The technical component (equipment and recording) is reported separately with CPT 93244. Some practices may bill globally if they own equipment and provide interpretation, but must verify payer allows combined billing.

What are common medical necessity requirements for CPT 93245?

Most payers require: documented cardiac symptoms (palpitations, syncope, presyncope), failed or non-diagnostic shorter-duration monitoring (24-48 hour Holter), clinical indication supporting need for extended observation (paroxysmal arrhythmias), or specific conditions like cryptogenic stroke evaluation. Prior authorization may be required by some commercial payers.