CPT 93248Cardiology

Ext ecg>7d<15d rev&interpj

CPT code 93248 covers the physician's review and interpretation of extended heart rhythm monitoring data collected over 7 to 15 days using a wearable heart monitor or patch device. This is the analysis portion only, not the technical recording itself.

Showing rates for

National Average

Base Medicare rate

$24.26

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)

0.18

MP RVU

0.02

Total RVU

0.75

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

NCCI bundling edits

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Billing tips

Verify the exact monitoring duration in documentation before code selection - 93248 is only for >7 days to <15 days; use 93247 for ≤7 days or 93270-93272 for ≥15 days
Impact: Incorrect duration coding is the #1 denial reason for this code family; can result in underpayment of $10-40 or complete denial requiring resubmission
Bill 93248 only once per monitoring period regardless of how many times the physician reviews interim data; this is a per-episode code, not per-review
Impact: Duplicate billing attempts will be denied and may trigger pre-payment audits; protects against compliance risk worth thousands in potential recoupment
Submit claim only after the complete monitoring period has ended and final interpretation is documented; do not bill based on device application date
Impact: Premature billing before monitoring completion results in 30-40% denial rate; date of service should be the interpretation date, not application date
Document patient symptom correlation with specific time stamps matching ECG findings in the interpretation report; generic interpretations increase audit risk
Impact: Detailed symptom-rhythm correlation reduces denial rate by approximately 25% and strengthens medical necessity for extended monitoring duration
Separate technical component (93246) and professional component (93248) billing when your facility provides both services; understand split-billing arrangements
Impact: Ensures capture of full reimbursement potential; technical component pays significantly more than professional, total combined approximately $150-200
Verify patient compliance with wearing device for minimum required percentage of monitoring period (typically 80%+); document compliance percentage in report

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Frequently asked questions

What is the difference between CPT 93248 and 93247?

CPT 93247 is for extended ECG monitoring up to 7 days, while 93248 covers monitoring periods greater than 7 days but less than 15 days. The code selection depends entirely on the actual duration of monitoring recorded in the device report. If monitoring was 7 days or less, use 93247; if it extended beyond 7 days but remained under 15 days, use 93248.

How much does Medicare pay for CPT code 93248 in 2025?

The 2025 Medicare national average reimbursement for CPT 93248 is $24.26 for both facility and non-facility settings. This represents the professional component only (physician interpretation). The code has 0.75 total RVUs (0.55 work RVU, 0.18 practice expense RVU, 0.02 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can I bill 93248 and 93015 together on the same day?

Yes, CPT 93248 (extended ECG interpretation) and 93015 (treadmill stress test interpretation) can be billed together if both services are medically necessary and separately documented. These represent different diagnostic modalities - one is ambulatory monitoring interpretation and the other is exercise stress testing. Use modifier 59 on the secondary code if required by the payer to indicate distinct services.

Who can bill CPT code 93248?

CPT 93248 should be billed by or under the supervision of a qualified physician with expertise in ECG interpretation, typically cardiologists or cardiac electrophysiologists. The interpreting physician must personally review the monitoring data, correlate findings with patient symptoms, and provide a signed written report. Primary care physicians with appropriate training may also bill this code if they perform and document the interpretation themselves.

What documentation is required to bill 93248?

Required documentation includes: exact monitoring start/end dates with duration calculation, patient compliance data, complete rhythm analysis, symptom-ECG correlation with time stamps, clinical impression, physician signature and credentials, and medical necessity justification for the 7-15 day monitoring period. The report must demonstrate review of the entire monitoring period, not just selected segments.

Is CPT 93248 a professional or technical component?

CPT 93248 represents the professional component only - the physician's interpretation and report of the extended ECG monitoring data. The corresponding technical component (device hookup, recording, supplies, and technician services) is reported separately with CPT 93246. Some practices bill both codes when they provide complete services; others bill only 93248 when interpreting recordings performed elsewhere.

How often can CPT 93248 be billed for the same patient?

CPT 93248 should be billed once per complete monitoring episode. There is no specific frequency limitation, but medical necessity must support repeat extended monitoring. Most payers allow repeat monitoring after resolution of initial findings, medication changes, or new symptom onset. Billing 93248 multiple times within a short period (30-60 days) without clear clinical justification will likely trigger medical necessity review and require detailed documentation supporting each episode.