CPT 93297Cardiology

Rem interrog dev eval icpms

CPT 93297 is used when a healthcare provider remotely checks a patient's implanted heart device (like a pacemaker or defibrillator) without the patient coming into the office. The device transmits data electronically so doctors can monitor heart rhythm and device function from a distance.

Showing rates for

National Average

Base Medicare rate

$58.22

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

0.52

PE RVU (NF)

1.25

MP RVU

0.03

Total RVU

1.8

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

NCCI bundling edits

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Billing tips

Verify the full 90-day monitoring period has elapsed since the last remote interrogation before billing 93297
Impact: Prevents denials for services billed too frequently; saves approximately $58.22 per prevented denial and reduces appeals workload
Document the specific date range of the 90-day monitoring period and confirm at least one remote transmission was received and reviewed
Impact: Essential for medical necessity; lack of documented transmission is the leading cause of denials resulting in $58.22 loss per claim
Do not bill 93297 in conjunction with in-person device interrogation codes (93289, 93295, 93296) during the same 90-day period unless separate medical necessity is documented
Impact: Prevents bundling denials and potential recovery of overpayments; in-person interrogations typically reimburse higher and would take precedence
Separate professional and technical components appropriately when using third-party remote monitoring services
Impact: Ensures proper payment split; modifier 26 typically yields approximately 60-70% of total RVU value while TC yields 30-40%
Confirm patient enrollment in remote monitoring program is documented in the medical record with signed consent
Impact: Required for compliance; missing enrollment documentation can trigger retrospective denials and recoupment of payments
Bill only one unit of 93297 per device per 90-day period regardless of number of transmissions received
Impact: Medicare allows only one remote interrogation service per 90 days; multiple units billed will be denied and adjusted to one unit ($58.22)

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93297 in 2025?

The 2025 Medicare national average reimbursement for CPT 93297 is $58.22 for both facility and non-facility settings. This rate is based on 1.8 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How often can CPT 93297 be billed for the same patient?

CPT 93297 can be billed once per 90-day period per device. You cannot bill this code more frequently even if multiple transmissions are received. The 90-day period begins with the date of the previous remote or in-person interrogation and must be fully completed before billing again.

What is the difference between CPT 93297 and 93296?

CPT 93297 is for remote interrogation device evaluation of pacemakers and ICDs, while 93296 is for in-person interrogation device evaluation of the same devices. Remote services (93297) use transmitted data without patient presence, while 93296 requires the patient to be physically present in the office or facility.

Can CPT 93297 be billed with modifier 26 for professional component only?

Yes, modifier 26 can be appended to 93297 when billing only the professional component (physician interpretation). This is common when a third-party monitoring service provides the technical component. The monitoring company would bill with modifier TC for their portion of the service.

What documentation is required to bill CPT 93297?

Required documentation includes the 90-day monitoring period dates, confirmation of remote transmission receipt, device parameters (battery, leads, impedance), arrhythmia data, physician interpretation with signature and date, clinical action taken, and evidence of patient enrollment in the remote monitoring program.

Does CPT 93297 include both pacemaker and ICD remote monitoring?

Yes, CPT 93297 covers remote interrogation for both pacemakers and implantable cardioverter-defibrillators (ICDs), including single, dual, and multiple lead systems. The same code applies regardless of device complexity, with reimbursement of $58.22 for all device types.

Can CPT 93297 be billed with an in-person device check on the same day?

No, CPT 93297 should not be billed with in-person device interrogation codes (93289, 93295, 93296) for the same device during overlapping 90-day periods. If an in-person check is performed, it typically supersedes the remote monitoring service unless separate medical necessity is clearly documented for distinct monitoring periods.