CPT 93790Cardiology

Ambl bp mntr w/sw i&r

CPT code 93790 covers the physician's interpretation and report of ambulatory blood pressure monitoring data, where a patient wears a portable device that automatically measures blood pressure over 24 hours or longer.

Showing rates for

National Average

Base Medicare rate

$17.14

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

0.38

PE RVU (NF)

0.14

MP RVU

0.01

Total RVU

0.53

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

NCCI bundling edits

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Billing tips

Always verify that the technical component (93784) was billed separately or as part of a global code (93786) - do not bill 93790 if 93786 was already submitted
Impact: Prevents bundling denials and potential $17.14 payment reversal
Ensure the written interpretation includes analysis of at least 12 hours of usable data with minimum 70% valid readings per ACC/AHA guidelines
Impact: Studies with inadequate data may be denied entirely; resubmission requires repeat monitoring
Document specific blood pressure thresholds analyzed (daytime, nighttime, dipping patterns) and clinical correlation with patient symptoms or medication timing
Impact: Detailed documentation reduces medical necessity denials by 40-60%
Bill 93790 within 7-10 days of monitoring completion but separate from the date of equipment hookup (93784)
Impact: Dating errors can trigger same-day bundling edits or incorrect global period assumptions
Link to appropriate hypertension diagnosis codes (I10, I15.x series) or symptom codes (R03.0 for elevated BP reading) to establish medical necessity
Impact: Missing or incorrect diagnosis codes account for 25% of denials for this service
For Medicare patients, ensure documentation supports coverage criteria including failed office BP management or suspected white-coat/masked hypertension
Impact: Medicare LCD violations result in complete denial of $17.14 payment with low appeal success rate

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 93790 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 93790 is $17.14 for both facility and non-facility settings, based on 0.53 total RVUs and the 2025 conversion factor of 32.3465.

Can CPT 93790 be billed on the same day as the equipment hookup?

Yes, but 93790 should be billed on the date the physician completes the interpretation and report, not the hookup date. The technical component (93784) is billed on the hookup date, while 93790 is typically billed 1-3 days later after monitoring completion and data analysis.

What is the difference between CPT 93790 and 93786?

CPT 93790 is the professional component only (interpretation and report), while 93786 is the global code that includes both the technical component (equipment, recording) and professional component (interpretation). Bill 93790 only when another entity provides the equipment and you're performing interpretation only.

How many blood pressure readings are required for billing CPT 93790?

While CPT does not specify an exact number, clinical standards require at least 12 hours of monitoring with minimum 70% valid readings (typically 14-20 valid readings) to produce clinically meaningful results. Studies with insufficient data should be repeated rather than billed with modifier 52.

What diagnosis codes are typically used with CPT 93790?

Common diagnosis codes include I10 (essential hypertension), I15.0 (renovascular hypertension), I15.8 (other secondary hypertension), R03.0 (elevated blood pressure reading), and Z79.4 (long-term use of insulin) when evaluating diabetic patients with hypertension.

How often can CPT 93790 be billed for the same patient?

Most payers allow ABPM 1-2 times per year with documented medical necessity. More frequent monitoring requires documentation of significant clinical changes such as medication adjustments for resistant hypertension, new symptoms, or inadequate initial study requiring repeat monitoring.

Do non-physician practitioners get paid the same rate for CPT 93790?

Nurse practitioners and physician assistants are reimbursed at 85% of the physician fee schedule rate when billing under their own NPI, which would be approximately $14.57 for 93790. However, many cardiology practices have NPPs perform interpretations under physician supervision and bill under the supervising physician's credentials.