Universal ECG™ Reimbursement
Printable version of EKG Reimbursement.
Source: November 2006 Federal Register publications of Final Rule Medicare Program’s Fee Schedule for Physician’s Services for Calendar Year 2007 and the Tax Relief and Health Care Act of 2006.
Printable version of EKG Reimbursement. Source: November 2006 Federal Register publications of Final Rule Medicare Program’s Fee Schedule for Physician’s Services for Calendar Year 2007 and the Tax Relief and Health Care Act of 2006.
The following common procedure terminology codes (CPT Codes) describe the various resting electrocardiograph procedures and the national average reimbursement amount. For ECG monitoring, see 99354 – 99360.
They include, but are not limited to:
| Comprehensive Code |
Component Code |
Description | National Fee |
| 93000 | 93005, 93010, 93040, 93041, 93042 |
Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report. | $24.86 |
| 93005 | 93040, 93041, 93042 |
Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report. | $16.46 |
| 93010 | 93040, 93041, 93042 |
Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only. | $8.41 |
| 93012 | 93268 | Telephonic transmission of post-symptom electrocardiogram rhythm strip(s), 24-hour attended monitoring, per 30 day period of time; tracing only. | $219.57 |
| 93040 | 93041, 93042, 93268 |
Rhythm ECG, one to three leads; with interpretation and report. | $13.75 |
| 93041 | Rhythm ECG, one to three leads; tracing only without interpretation and report. | $6.12 | |
| 93042 | 92968, 93272 | Rhythm ECG, one to three leads; interpretation and report only. | $7.64 |
Electrocardiography ICD-9 Codes
The following ICD-9 Codes support the medical necessity for the use of an electrocardiograph. They include, but are not limited to:
| 240 – 246.9 | Disease of thyroid gland |
| 245 - 245.9 | Thyroiditis |
| 243 | Congenital Hypothyroidism |
| 304 – 304.93 | Drug dependency |
| 276.7 | Hyperpotassemia |
| 410 – 414.9 | Ischemic heart disease |
| 401 – 405.99 | Hypertensive disease |
| 420 – 420.99 | Acute pericarditis |
| 415 – 417.9 | Disease of pulmonary circulation |
| 428 – 428.9 | Heart failure |
| 422 – 422.99 | Acute myocarditis |
| 648.6 – 648.64 | Other cardiovascular diseases |
| 648.5 – 648.54 | Congenital cardiovascular disease |
| 669.1 – 669.14 | Shock during or following labor and delivery |
| 669 – 669.04 | Maternal distress |
| 780.4 | Dizziness and giddiness |
| 780.7 | Malaise and fatigue |
| 785.1 | Palpitations |