CPT 93247Cardiology

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

CPT 93247 covers the analysis and report of extended heart rhythm monitoring using a wearable device for 7 to 15 days. This is a scan and report service for continuous ECG recordings that help detect irregular heartbeats or other cardiac rhythm problems.

Showing rates for

National Average

Base Medicare rate

$234.84

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)

7.25

MP RVU

0.01

Total RVU

7.26

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

NCCI bundling edits

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Billing tips

Bill 93247 only once per monitoring period, regardless of how many days within the 7-15 day range the patient was monitored
Impact: Prevents denials for duplicate billing; ensures compliance as this is a per-episode code, not a per-day code
Verify the exact monitoring duration before code selection - use 93224-93227 for up to 48 hours, 93241-93243 for up to 7 days, and 93247-93248 for 7-15 days
Impact: Using incorrect duration code can result in $50-150 underpayment or overpayment and potential audit flags
Ensure the physician's interpretation report includes analysis of all significant arrhythmias, total monitoring time, patient symptom correlation, and clinical recommendations
Impact: Incomplete reports are the #1 cause of medical necessity denials; complete documentation supports the full $234.84 reimbursement
Do not bill hookup, removal, or patient education codes separately as these are bundled into the monitoring service
Impact: Unbundling can trigger audits and recoupment demands; all setup services are included in the $234.84 rate
Confirm prior authorization was obtained before monitoring begins, as many commercial payers require pre-approval for extended monitoring beyond 48 hours
Impact: Retroactive authorization denials result in 100% payment loss ($234.84); prior auth compliance improves first-pass payment rate by 85%+
Submit claims within 30 days of completed analysis to avoid timely filing denials, particularly important for monitoring that spans multiple calendar months
Impact: Timely filing denials are rarely overturned; prompt billing ensures the full $234.84 payment is not forfeited

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 93247 in 2025?

The 2025 Medicare national average reimbursement for CPT 93247 is $234.84 for both facility and non-facility settings. This rate is based on 7.26 total RVUs multiplied by the 2025 conversion factor of 32.3465. Local Medicare Administrative Contractors (MACs) may have slight geographic variations.

How many days of monitoring does CPT 93247 cover?

CPT 93247 covers extended ECG monitoring analysis for more than 7 days but less than 15 days of continuous recording. If monitoring is 7 days or less, use codes 93241-93243 instead. If monitoring exceeds 15 days, use code 93248 or 93270-93272 for implantable/external loop recorders.

Can CPT 93247 be billed more than once during the same monitoring period?

No, CPT 93247 should only be billed once per monitoring episode regardless of how many days within the 7-15 day range the patient was monitored. This is a per-episode code that captures the complete analysis and reporting of all data from one continuous monitoring period.

What is the difference between CPT 93247 and 93243?

CPT 93247 covers ECG monitoring analysis for 7-15 days, while 93243 covers monitoring for up to 7 days. The key distinction is monitoring duration. Both codes represent the scanning, analysis, and physician report, but 93247 applies to longer monitoring periods that may detect intermittent arrhythmias missed on shorter studies.

Do I need prior authorization for CPT 93247?

Medicare typically does not require prior authorization for 93247, but many commercial payers and Medicare Advantage plans do require pre-approval for extended cardiac monitoring beyond 48 hours. Always verify authorization requirements with the specific payer before initiating monitoring to avoid claim denials.

What documentation is required to bill CPT 93247?

Required documentation includes exact monitoring dates (proving >7 but <15 days), total analyzable recording time, complete rhythm analysis with arrhythmia quantification, representative ECG strips, symptom-rhythm correlation, physician interpretation with clinical recommendations, and the physician's signature with credentials and date. Medical necessity documentation supporting the indication is also essential.

Can CPT 93247 be billed with modifier 26 or TC?

Yes, 93247 can be split with modifier 26 (professional component for interpretation only) or TC (technical component for equipment and recording) when different entities provide these services. However, the published Medicare rate of $234.84 represents the global service, and component billing would result in different payment amounts allocated between technical and professional portions.