For years, CPT code 93296 has been the standard for reimbursing the technical component of remote cardiac monitoring. But the field has changed—dramatically. And that code? It hasn't.
What 93296 Was Designed For
Originally, 93296 reimbursed for a fairly straightforward task: receiving and reviewing pacemaker data. It was intended for a simple workflow involving minimal human input. But today's remote monitoring environment is far more complex, involving high-volume data, algorithm-based filtering, 24/7 alerting, clinical triage, and real-time decision-making.
Today’s Monitoring = Clinical Care
Practices are doing far more than transmitting data. They’re triaging events, escalating findings to physicians, making patient calls, documenting interventions, and tracking compliance. Every transmission requires review and often clinical decision-making. That’s real clinical work—and the reimbursement rate doesn’t come close to matching the time, resources, and expertise required.
The Administrative Burden Has Grown Too
It's not just clinical work that has increased. Documentation requirements, billing complexities, and insurance audits have all added to the administrative load. Practices are juggling multiple systems just to meet the minimum requirements for accurate billing and compliance.
What’s at Stake
- Clinics may reduce monitoring if it’s financially unsustainable
- Patient care could suffer due to delays or reduced oversight
- Staff burnout continues to rise without adequate support or resources
- Smaller or rural practices may stop offering these services altogether
A Call for Change
Rhythm has joined a national coalition to call for the revaluation of CPT code 93296. It’s not just about fair payment—it’s about protecting the integrity of cardiac care. Updating reimbursement models to reflect today’s reality is essential to support sustainable, high-quality patient monitoring.
We believe in aligning reimbursement with the actual clinical and technical labor being provided. Until that happens, practices will continue to shoulder an unsustainable burden for delivering a critical service.