Frequently Asked Questions
Q. How much does remote pacemaker monitoring cost?
A. Remote pacemaker monitoring is medical service covered by Medicare and most commercial insurance companies. It consists of two unique CPT codes. CPT 93294 (Professional) covers the physician interpretation of a patient’s transmissions during the 90 day monitoring period. Regardless of the number of transmissions that take place, this code is only billed once. CPT 93296 (Technical) covers the active monitoring and review of all transmissions during a given monitoring period. CPT 93294 is reimbursed between $32 and $40 per 90 day period. CPT 93296 is reimbursed between $25 and $35 per 90 day period. For more detailed pricing information for your area, visit: https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx
Q. How does remote pacemaker monitoring work?
A. Most current pacemakers that are implanted today are enrolled in remote patient monitoring. This allows the patient’s device to be paired with a wireless or wired transmitter that is placed in the patient’s home. It has the ability to automatically sync up any patient or device related data and upload it to the respective manufacturer’s website for review by a qualified medical professional. This is a continuous process and should be maintained for the life of the device.
Q. How often should a pacemaker be interrogated?
A. Most remote capable devices should be actively monitored continuously. At a minimum, the device should upload all of its current device parameters and settings including battery voltage and lead impedance at least once per every 90 days. Other arrhythmia or device related triggers can also be programmed to automatically be sent immediately upon occurrence. This remote monitoring is separate from a “in person interrogation” or reprogramming that would take place in a medical facility. Separate billing codes are used for in person interrogation or reprogramming services.
Q. What is the technical CPT code for remote pacemaker monitoring?
A. The technical CPT code for remote pacemaker monitoring covers any and all transmissions (scheduled and unscheduled) for each 90 day period. CPT code 93296 should be billed 4 times per year for routine remote pacemaker monitoring.
Q. What is the professional CPT code for remote pacemaker monitoring?
A. The professional CPT code for remote pacemaker monitoring covers the review and physician interpretation for all transmissions that take place within a 90 day period. CPT 93294 should be billed in conjunction with CPT 93296 on a schedule of 4 times per year.
Q. How often can you bill 93296?
A. Both CPT codes 93294 and 93296 can be billed a maximum of 4 times per year. For example, remote monitoring services for day 1 through day 90 should be billed on day 91. Both CPT codes are only billed once per billing period, regardless of the number of transmissions or reports that are created and reviewed.
Q. Is the remote monitoring CPT code the same for single or dual chamber devices?
A. Yes. For remote pacemaker monitoring, both single and dual chambered device are billed with CPT 93294 and CPT 93296.
Q. Can both a device reprogramming and a remote technical monitoring be billed in the same month?
A. Yes. If a patient is being monitored remotely and a device abnormality is detected that requires device reprogramming, the patient should be brought into the office for a full reprogramming session. This session has its own separate set of billing codes based on the type of device and the number of chambers. This session should not interrupt the remote monitoring schedule. Consult with your device manufacturer or clinical specialist for additional information on in person reprogramming and interrogation services.
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, or leadless pacemaker system with interim analysis, review(s) and report(s) by a physician or other qualified healthcare professional.
Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or multiple lead pacemaker system, leadless pacemaker system, or implantable defibrillator system, remote data acquisition(s), receipt of transmissions and technician review, technical support and distribution of results.