Tte f-up or lmtd
CPT code 93308 represents a follow-up or limited transthoracic echocardiogram (heart ultrasound), typically performed to check specific findings from a previous complete echo or to monitor a known cardiac condition.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Clearly document why a limited study (93308) is appropriate rather than a complete echo (93306) - specify the focused clinical question or which previously identified finding is being reassessed
Impact: Prevents downcoding denials and medical necessity challenges that could result in $94.45 claim denial
When billing global service, ensure both technical and professional components are documented; if services are split, append modifier 26 (professional) or TC (technical) appropriately
Impact: Incorrect component billing can result in overpayment recovery or underpayment; proper split billing ensures accurate reimbursement
Verify frequency limitations with payer policies - most Medicare contractors limit follow-up echos to specific intervals based on diagnosis (e.g., every 3-6 months for valve disease)
Impact: Frequency violations are a common denial reason; spacing studies appropriately can prevent $94.45 denials
Do not bill 93308 on the same date as 93306 (complete echo) for the same patient unless performed for entirely separate clinical indications and properly modified
Impact: CCI edits typically bundle these codes; inappropriate billing leads to automatic denials
Include specific measurements and comparisons to prior studies in the report when billing as follow-up; generic reports trigger audits
Impact: Detailed comparative documentation reduces audit risk and supports medical necessity
Confirm pre-authorization requirements for non-Medicare payers; many commercial insurers require prior auth for all echocardiography
Impact: Missing authorization can result in complete claim denial regardless of medical necessity
Common denials
Medical necessity not established - payer determines a complete echo (93306) should have been performed instead of limited study
How to appeal: Submit appeal with clinical documentation clearly stating the focused clinical question, reference to prior complete echo findings being reassessed, and explanation of why limited study was sufficient. Include relevant guidelines supporting interval follow-up for the specific condition.
Frequency limitation exceeded - study performed too soon after previous echocardiogram based on payer's LCD/NCD
How to appeal: Provide documentation of clinical change or new symptoms that justified earlier repeat study. Include physician notes describing why waiting was not clinically appropriate. Reference specific clinical events (e.g., syncope, new murmur, post-procedure assessment).
Bundled with same-day procedure or E/M service due to CCI edits
How to appeal: If services were truly distinct and separately identifiable, appeal with documentation showing separate medical necessity and append appropriate modifier (typically 59 or 25 for E/M). Demonstrate that the echo was not part of the other procedure's standard protocol.
Incomplete documentation - report lacks required elements or measurements for a limited study
How to appeal: Submit corrected or addended report with all required elements including indication, technical quality statement, specific findings for structures examined, measurements, comparison to prior studies, and final impression. Request reconsideration based on complete documentation.
Frequently asked questions
What is the difference between CPT 93308 and 93306?
CPT 93306 is a complete transthoracic echocardiogram that includes comprehensive evaluation of all cardiac structures, chambers, valves, and hemodynamics. CPT 93308 is a limited or follow-up study that focuses on specific structures or reassesses previously identified findings. The limited study (93308) is appropriate when the clinical question can be answered without examining all cardiac structures comprehensively.
How much does Medicare pay for CPT 93308 in 2025?
The 2025 Medicare national average payment rate for CPT 93308 is $94.45 for both facility and non-facility settings. This is based on 2.92 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary based on geographic location and MAC adjustments.
Can CPT 93308 be billed with an E/M visit on the same day?
Yes, CPT 93308 can be billed with an E/M service on the same day if the E/M service represents a separately identifiable service beyond the typical pre- and post-service work of the echo. Append modifier 25 to the E/M code and ensure documentation clearly supports both services as distinct and medically necessary.
How often can CPT 93308 be billed for the same patient?
Frequency limitations for CPT 93308 vary by payer and diagnosis. Medicare typically covers follow-up echos at intervals appropriate to the condition being monitored (e.g., every 3-6 months for moderate to severe valve disease, annually for mild disease). Medical necessity must be documented for each study, and more frequent studies require documentation of clinical change or new symptoms.
What documentation justifies billing 93308 instead of 93306?
Documentation must clearly state the focused clinical question that can be answered with a limited study, such as 'reassess severity of known mitral regurgitation' or 'evaluate pericardial effusion size compared to prior study.' Reference to previous complete echo findings and explanation of which specific structures need reassessment supports the use of 93308 over the complete study.
Do I need modifier 26 or TC when billing CPT 93308?
Use modifier 26 when billing only the professional component (physician interpretation) if the technical component is performed by a separate entity. Use modifier TC when billing only the technical component (equipment and sonographer) if interpretation is done separately. Bill without modifiers (global code) only when the same entity performs both technical and professional components.
What are the Work RVUs for CPT code 93308?
CPT 93308 has 0.53 Work RVUs, 2.35 Practice Expense RVUs (both facility and non-facility), and 0.04 Malpractice RVUs, totaling 2.92 RVUs for 2025. This reflects the reduced physician work and resources compared to a complete echocardiogram which has significantly higher RVU values.