CardioNet System Receives Category I CPT Codes and Reimbursement Rates
November 3, 2008 - CardioNet Inc. a wireless medical technology company with a focus on the diagnosis and monitoring of cardiac arrhythmias, today said the Centers for Medicare and Medicaid Services (CMS) has established reimbursement rates that cover the CardioNet System.
The reimbursement rates are applicable to the Category I CPT codes established by the American Medical Association (AMA) and published on Oct. 10 for mobile cardiovascular telemetry. The codes and rates are contained in The Medicare Program Final Rule for the calendar year 2009 and will become effective on Jan. 1.
The 2009 national reimbursement rate for the technical component related to use of the CardioNet System (CPT code 93229) has been carrier priced, meaning, similar to today, Highmark Medicare Services will continue to be responsible for the reimbursement rate for this new code. The current technical reimbursement rate established by Highmark Medicare Services is $1,123. The company believes the current technical reimbursement rate will positively impact its growth prospects for 2009 and beyond.
The new billing codes will allow for automated claims adjudication, substantially simplifying the reimbursement process for physicians and payors compared to the current process. Reimbursement is currently obtained through non-specific billing codes which require various narratives that, in most cases, involve semi-automated or manual processing, as well as additional review by payors.
The new Category I CPT codes, which were established by the AMA for the professional and technical components associated with the CardioNet System, are:
1.) CPT code 93228 - Wearable mobile cardiovascular telemetry with electrocardiographic recording, concurrent computerized real time data analysis and greater than 24 hours of accessible ECG data storage (retrievable with query) with ECG triggered and patient selected events transmitted to a remote attended surveillance center for up to 30 days; physician review and interpretation with report
2.) CPT code 93229 - Technical support for connection and patient instructions for use, attended surveillance, analysis and physician prescribed transmission of daily and emergent data reports
For more information: www.cardionet.com
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