Medicare rebate changes - Cardiac Monitoring Service
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Rates for Extended Wear Holter (EWH) are increasing in 2021. The changes to the codes have been made in recognition of the associated time and work to monitor, detect and analyze cardiac results over longer periods, which have been recognized to increase detection.
Extended Wear Holter (EWH) with monitoring lengths of 3-7 days and 8+ days will be covered by Medicare.
Reimbursement rates are yet to be finalized.

Starting January 2021, Holter services will be catergorized by the length of Holter test

  • Up to 48hrs
  • More than 48hrs, up to 7 days
  • More than 7 days, up to 15 days

 

 

Medicare changes FAQs

 

The 1st of January 2021

The official rates for Cardiac Monitoring Service wont be known until the end of December.

Yes. CNM, CNS, NP, and PA would be able to prescribe and bill for services including MCT and EWH.

The plans of the commercial payors have yet to be announced. Not all payors policies allow for Extended Wear Holter or may require pre-authorization for these services.

The OPPS system is designed to cover the administration labor costs of these tests by in-facility staff, and do not pay for the test itself. OPPS-equivalents to the PFS codes are also proposed for 2021, which do not have substantial differences in payments between 1-2 day and the EWH services.

We offer multiple billing models

Our myPatch clients can choose split fee or fee for service billing.