CPT 93246Cardiology

Ext ecg>7d<15d recording

CPT code 93246 covers the technical recording component of an extended heart rhythm monitor worn by a patient for more than 7 days but less than 15 days. This is just the recording portion; the physician's interpretation of the data is billed separately.

Showing rates for

National Average

Base Medicare rate

$11.32

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

PE RVU (NF)

0.34

MP RVU

0.01

Total RVU

0.35

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

NCCI bundling edits

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Billing tips

Always verify the exact duration of monitoring (must be >7 days but <15 days) and document start and end dates precisely
Impact: Incorrect duration coding is the #1 cause of denials; using 93246 for 6-day monitoring instead of 93245 results in 100% claim rejection
Bill 93246 (technical) and 93248 (professional interpretation) separately unless you own both components
Impact: Failing to bill the interpretation code 93248 ($44.40 in 2025) leaves significant revenue on the table for providers performing both services
Ensure LCD/NCD compliance for medical necessity, particularly diagnosis codes supporting extended monitoring beyond standard Holter duration
Impact: Medicare requires documented rationale for extended monitoring; lack of supporting diagnosis codes results in 30-40% denial rates
Verify patient returned equipment and data was successfully transmitted/analyzed before submitting claim
Impact: Claims submitted without complete data collection are not reimbursable and will be denied; confirm minimum 7-day data capture
Do not bill 93246 with same-day Holter codes (93224-93227) or other external monitoring codes for overlapping time periods
Impact: Bundling edits will deny the claim; CMS considers these mutually exclusive for the same monitoring period
Check for frequency limitations; Medicare typically allows one extended monitoring study per patient per indication within specific timeframes
Impact: Repeat studies within 30-90 days often denied without compelling clinical change documentation; appeals can recover $11.32 per service

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Frequently asked questions

What is the difference between CPT 93246 and 93248?

CPT 93246 is the technical component covering equipment, recording, and data collection for 7-15 day monitoring ($11.32). CPT 93248 is the professional component covering physician interpretation and report ($44.40). Facilities bill 93246, physicians bill 93248, and entities performing both services bill both codes.

How much does Medicare pay for CPT code 93246 in 2025?

Medicare pays $11.32 for CPT 93246 in 2025 based on the national average rate. This rate is the same for both facility and non-facility settings. The code has 0.35 total RVUs (0 work RVU, 0.34 PE RVU, 0.01 MP RVU).

Can CPT 93246 be billed with a modifier 26 for professional component?

No, CPT 93246 should not be billed with modifier 26. This code represents only the technical component of extended ECG recording. For the professional interpretation component, use CPT code 93248 instead. The code structure separates technical and professional services into distinct codes.

What monitoring duration qualifies for CPT 93246?

CPT 93246 requires monitoring duration of more than 7 days but less than 15 days. For 7 days or less, use CPT 93245. For 15 days or more, use CPT 93247. Exact start and end timestamps must be documented to support the duration billed.

What diagnosis codes support medical necessity for CPT 93246?

Common supporting diagnoses include R55 (syncope), R00.2 (palpitations), I48.91 (atrial fibrillation), I49.9 (cardiac arrhythmia unspecified), and I47.1 (supraventricular tachycardia). Documentation should explain why extended 7-15 day monitoring is necessary rather than shorter Holter monitoring, typically citing infrequent symptom occurrence.

How often can CPT 93246 be billed for the same patient?

Medicare typically allows extended cardiac monitoring once per clinical indication within specific timeframes, often 30-90 days. Repeat studies require documentation of new symptoms, interim clinical changes, medication adjustments, or post-procedure surveillance needs. Check local coverage determinations (LCDs) for specific frequency limitations.

Can CPT 93246 be billed with Holter monitor codes on the same date?

No, CPT 93246 should not be billed with Holter codes (93224-93227) or other external cardiac monitoring codes (93241-93245, 93247) for overlapping time periods. These codes are mutually exclusive. Bill only one external monitoring code per distinct monitoring episode with non-overlapping dates of service.