The 93268 CPT code reports the global service for an external cardiac event monitor worn up to 30 days. One entity bills it once per episode for the hook-up, the recording, 24-hour attended monitoring, transmission review, and the physician’s interpretation. Medicare’s 2026 national rate is $169.68.
The work split decides the code. Picking the right cardiac event monitor CPT code starts with who placed the device, who watched the transmissions, and who read the strips. Practices lose money when they bill global after a vendor ran the monitoring, append 26 or TC, or stack components on the global code.
We checked this 93268 CPT code guide against Medicare contractor billing articles, CPT Assistant guidance from AAPC’s cardiology newsletter, and payer policies in effect on October 1, 2026. The cardiology billing team at One O Seven RCM wrote it. Key rules link to their primary sources.
Key takeaways
- CPT code 93268 is the global code, and 93270, 93271, and 93272 are its components.
- One entity bills one unit per monitoring episode of up to 30 days.
- Medicare’s 2026 national rate is $169.68: 5.08 RVUs times the $33.4009 non-QP conversion factor.
- Modifiers 26 and TC don’t apply to the event monitor codes.
- UnitedHealthcare treats 93268 as a 30-day time-span code, and Horizon BCBSNJ pays it once in six months.
- Noridian, Palmetto GBA, and CGS put new cardiac monitoring LCDs into effect in June 2026.
Quick facts for 93268 in 2026
| Field | 2026 value |
|---|---|
| Code | 93268 (CPT Category I) |
| Service | Global external event monitoring |
| Wear period | Up to 30 days |
| Units | 1 per monitoring episode |
| 2026 Medicare national rate | $169.68 (non-QP) |
| Modifiers 26 and TC | Not used |
| Component codes | 93270, 93271, 93272 |
What Is CPT Code 93268?
CPT code 93268 is the global code for external cardiac event monitoring. The code covers a patient-activated or auto-activated recorder with a symptom-related memory loop, worn up to 30 days, plus 24-hour attended monitoring, transmission review, and the physician’s signed report. One billing entity reports the whole package.
The 93268 CPT code sits in the Cardiovascular Monitoring Services section of CPT Category I, at the top of the 93268 to 93272 family. Medicare’s short descriptor reads “ECG record/review.” Some lookup sites took that label at face value and now describe 93268 as a plain ECG code.
The 93268 CPT Code Description in Plain Billing Terms
Each phrase in the 93268 CPT code description maps to a billable step. We paraphrased the AMA wording in the table below. If you quote the descriptor in an appeal letter or a compliance policy, copy it from your licensed CPT book.
What each part of the 93268 descriptor means on a claim
| Descriptor element | What it means | Billing consequence |
|---|---|---|
| External | Worn on the skin, not implanted | Implanted loop recorders bill 33285 and 93298 |
| Patient-activated and, when performed, auto-activated | The patient triggers recording; the device may auto-trigger | Auto-triggering doesn’t turn it into telemetry |
| Symptom-related memory loop | Saves the rhythm before and after a trigger | Separates it from Holter-style continuous storage |
| Remote download capability | Strips go to a monitoring center | Transmission logs become audit evidence |
| Up to 30 days | One monitoring episode | Early removal still counts as one unit |
| 24-hour attended monitoring | Staff receive transmissions around the clock | Without it, the service doesn’t fit 93268 |
| Transmission, review, and interpretation included | The physician’s read sits inside the code | Adding 93272 bills the read twice |
How an External Event Monitor Records and Transmits
Your patient presses a button when symptoms hit, or the device triggers on its own after it detects an abnormal rhythm. The memory loop keeps the seconds before the trigger. That lead-in shows your reading physician how the episode started.
Novitas article A59268 describes event monitors the same way, with up to 30 days of wear. A certified coder quoted in AAPC’s event monitor Q&A adds the billing point. Under 93268, someone has to staff 24-hour attended monitoring of the transmissions, and the descriptor for each event monitor CPT code in the family carries that requirement.
Is 93268 the Right Code? Event Monitor vs. Holter, Patch, MCT, and Loop Recorder
Device type decides the code. The cardiac event monitor CPT code family, 93268 to 93272, fits intermittent memory-loop recorders that the patient or the device activates, worn up to 30 days. Any other ambulatory cardiac monitor belongs to a different code family.
Before the 93268 CPT code goes on a claim, match it to the device named in the order. We built the table below from the monitor categories in Novitas A59268. If the order says “cardiac monitor” with no device type, ask the ordering provider before you code it.
Monitor types and code families, based on Novitas article A59268
| Device | How it records | Wear time | CPT codes |
|---|---|---|---|
| Holter | Continuous | Up to 48 hours | 93224 to 93227 |
| Extended external ECG | Continuous | Over 48 hours to 7 days | 93241 to 93244 |
| Extended external ECG | Continuous | Over 7 days to 15 days | 93245 to 93248 |
| Event monitor | Patient- or auto-activated, memory loop | Up to 30 days | 93268 to 93272 |
| Mobile cardiac telemetry | Real-time, attended | Up to 30 days | 93228, 93229 |
| Subcutaneous rhythm monitor (implantable loop recorder) | Implanted | Long-term | 33285 insertion; 93298 remote |
| External ECG, continuous | Continuous | Over 15 days to 30 days | 0937T to 0940T |
Implanted loop recorders follow a separate path with insertion code 33285 and remote interrogation code 93298; our 93298 loop recorder billing guide covers those claims.
What Is the CPT Code for a 30-Day Event Monitor?
The right 30-day event monitor CPT code depends on what the patient wore. A memory-loop event recorder goes in the 93268 family. For mobile cardiac telemetry, you bill 93228 and 93229. Continuous recording beyond 15 days goes to 0937T to 0940T, Category III codes with uneven payer coverage.
For a 14-day event monitor CPT code, check which of two devices the patient wore. A 14-day continuous patch goes to 93245 to 93248, while a 14-day event recorder with a memory loop stays in the 93268 family. You’ll find the device name on the order and on the vendor’s report.
Holter vs. Event Monitor: Two Separate Code Families
Holter monitoring records without a break for up to 48 hours, and you report it with 93224 to 93227. An event monitor captures triggered episodes over as many as 30 days. No Holter code covers 30 days, so ask the ordering provider to clarify any “30-day Holter” order before you bill it.
Our cardiology CPT codes guide covers the Holter and patch codes in detail, including the 48-hour cutoff and the 7-day and 15-day bands for extended monitoring.
93268 vs. 93270, 93271, and 93272: Global and Component Codes
Code 93268 is the global service. Its three components split the work: 93270 covers hook-up, recording, and disconnection; 93271 covers receipt and analysis of transmissions at the attended center; and 93272 covers the physician’s review and signed report. For one episode, you report the global code or the components each entity performed.
What Each Event Monitor Code Covers
Use the table below to see how each event monitor CPT code splits the service and which PC/TC indicator CMS assigns it. Indicator 4 marks a global-only test, 3 marks technical-only, and 2 marks professional-only. For hook-up details, see our 93270 hook-up guide. Read-only claims have their own walkthrough in our 93272 interpretation guide.
Event monitor code family, 2026
| Code | Component | What it covers | Usual billing entity | CMS PC/TC indicator |
|---|---|---|---|---|
| 93268 | Global | All of the service | One entity that does every part | 4 |
| 93270 | Technical: recording | Hook-up, instruction, recording, disconnection | Whoever hooks up the patient | 3 |
| 93271 | Technical: transmission and analysis | Receipt and analysis at the attended center | Monitoring center or IDTF | 3 |
| 93272 | Professional | Review, interpretation, signed report | Interpreting physician or QHP | 2 |
Why the Components Never Share an Episode With 93268
The AAPC Cardiology Coding Alert cites CPT Assistant Vol. 21, No. 10 for the rule: 93268 includes 93270, 93271, and 93272. Bill both, and you’ve charged for the same hook-up and the same read twice. Payers deny that pairing as bundled, and you’ll find the cleanup steps in our CO-97 bundling denials guide.
The same collision happens across two entities. If your practice bills 93268 and the monitoring vendor bills 93271 for the same window, the payer will deny one of the two claims, and it might be yours. Settle who bills what in the vendor contract before the first patient goes home with a monitor.
Report CPT 93268 or the components, never both, for the same patient and monitoring period. Your claim scrubber can’t catch the conflict when your 93268 CPT code line and a vendor’s component line sit on two different claims.
Who Can Bill 93268 Globally? A Three-Question Test
An entity bills 93268 when it furnishes all three parts of the service: hook-up and recording, attended monitoring and analysis, and the read. The certified coder in AAPC’s event monitor Q&A calls the most common error billing global when a vendor did part of the work.
You pick the CPT code for event monitor work by who did each piece. Answer three questions from the chart and your vendor contract:
- Does your practice supply the device and do the hook-up?
- Does your practice staff the 24-hour attended monitoring that receives and analyzes transmissions?
- Does your physician or QHP review, interpret, and sign the report?
Three yes answers mean you bill 93268 for one unit. A single no means each entity bills its own component.
Some practices buy the monitoring from a vendor and still bill 93268 under a contract. Before you try that, check your MAC’s purchased-service rules and your payer contracts. First Coast’s LCD L39492, for example, cites 42 CFR 414.50, the federal rule on billing for tests that an outside physician performs or interprets.
Three Common Setups and Who Bills What
You’ll see three arrangements on most cardiology accounts. Match yours to a row, then check that the vendor’s claims line up with your own before the first episode closes.
Who bills which event monitor code
| Setup | Your practice bills | Monitoring company or IDTF bills |
|---|---|---|
| Practice owns the device, runs the attended center, and reads | 93268 | Nothing |
| Practice hooks up and reads; vendor monitors | 93270 and 93272 | 93271 |
| Vendor ships or hooks up the device and monitors; practice reads | 93272 | 93270 and 93271 |
If your monitoring vendor and your billing team each think the other one bills the hook-up, you’ll find out through denials. Our team maps who bills each component before the first claim goes out, as part of our revenue cycle management services.
93268 Reimbursement in 2026: Medicare Rate and RVUs
The 93268 CPT code carries a 2026 Medicare national rate of $169.68 for non-QP clinicians: 5.08 total RVUs in the CMS RVU26D file times the $33.4009 conversion factor from the CY 2026 final rule. Qualifying APM participants use $33.5675, which works out to about $170.52. Your local rate moves with your locality’s geographic adjustment.
What the 5.08 RVUs Pay For
Work RVUs are 0.51, practice expense is 4.53, and malpractice is 0.04. Practice expense makes up about 89% of the code’s value. The money follows the equipment, the staff time, and the monitoring center far more than the physician’s read.
In CMS’s practice expense inputs, that share pays for technologist and nursing staff time, the looping event monitor equipment, and supplies like electrodes and batteries. A vendor that runs its own center collects most of the payment for that reason.
Global vs. Component Payment, Side by Side
Each component carries its own share of the 5.08 RVUs. Add the three components and you get $169.67, a cent below the global rate because of rounding.
2026 Medicare national rates, non-QP, from CMS RVU26D
| Code | Total RVU | 2026 national rate (non-QP) | Paid to |
|---|---|---|---|
| 93268 | 5.08 | $169.68 | The single entity |
| 93270 | 0.25 | $8.35 | Whoever hooks up |
| 93271 | 4.12 | $137.61 | Monitoring center |
| 93272 | 0.71 | $23.71 | Reading physician |
| Components combined | 5.08 | $169.67 | Rounding difference |
A practice that hooks up the patient and reads the strips, with a vendor running the center, collects $32.06 per episode. The vendor collects $137.61. Commercial payers set their own rates by contract, so pull your ERA averages for 93268 before you model anything. CMS resets the numbers on January 1, 2027.
Does CPT 93268 Need a Modifier?
Routine global billing for 93268 needs no modifier. Modifiers 26 and TC don’t belong on any code in the family, because CPT already splits the work into separate codes. CMS assigns 93268 PC/TC indicator 4, and the Medi-Cal cardiology manual says these codes aren’t payable with split-bill modifiers.
Why Modifiers 26 and TC Get Denied
Modifiers 26 and TC don’t apply to 93268. If you append one, you’re asking the payer for a component of a code whose components already exist as 93270, 93271, and 93272. Payers reject that as an invalid modifier combination, and the line comes back with CO-4.
Some code lookup pages still list 26 and TC as options for 93268. Billers who trust those pages send claims that come back denied. Our specialty medical billing services include a cardiology modifier review before submission, so our coders catch a stray 26 before the payer sees it.
When Modifiers 25, 59, 95, and GA Come Up
Four other modifiers come up around event monitor claims, and billers reach for a fifth one by mistake. Use these rules:
- Modifier 25 goes on a same-day E/M visit, not on 93268.
- Modifier 59 and the X modifiers don’t make it legal to bill components alongside the global code.
- Modifier 95 is payer-specific: CPT Appendix P lists 93268 to 93272, but the Aetna telemedicine policy doesn’t require the modifier on these codes, so check each payer before adding it.
- Modifier GA tells Medicare you have a signed ABN on file for a service you expect it to deny for medical necessity.
- Modifier 52 doesn’t fit early removal: the short-recording rule belongs to Holter codes, and the 93268 descriptor already says “up to 30 days.”
ICD-10 Codes That Support Medical Necessity for 93268
Medicare pays for event monitoring as a diagnostic test. Each 93268 CPT code claim needs a documented symptom or clinical sign, because Medicare NCD 20.15 excludes screening. Noridian’s 2026 response to comments on its new LCD treats routine monitoring without treatable symptoms as screening.
Symptom frequency decides whether an event monitor fits. Under Fallon Health’s coverage criteria, 93268 to 93272 fit symptoms that occur less often than every 48 hours but at least once a month. For daily or near-daily symptoms, Novitas LCD L39490 points to a 24-to-48-hour monitor, so your note has to explain the longer one.
Diagnoses Payers Accept Most Often
Novitas article A59268 lists 153 ICD-10 codes that support medical necessity for 93268 to 93272. Other MACs publish their own lists, so check yours. These examples come from the Novitas list:
Examples from Novitas article A59268’s 153 covered codes
| Category | Example ICD-10 codes | Note |
|---|---|---|
| Symptoms | R00.2, R55, R42, R00.0, R00.1, R06.02, R07.9 | Most common event monitor indications |
| Atrial fibrillation and flutter | I48.0, I48.11, I48.19, I48.20, I48.21, I48.91, I48.92 | Use the most specific type documented |
| Other arrhythmias | I47.11, I47.19, I49.1, I49.3, I49.5 | I47.1 left the code set in October 2023 |
| Conduction disorders | I44.0, I44.1, I44.2, I45.6, I45.81 | Heart blocks, long QT |
| Stroke and TIA | G45.9, I63.9, Z86.73 | A59268 reserves I63.9 for cryptogenic stroke |
Codes That Trigger Medical Necessity Reviews
Five coding patterns send CPT 93268 claims to medical necessity review or to an outright denial, so screen for them before you submit:
- I49.9 doesn’t appear on Novitas A59268’s covered list, so code the specific rhythm.
- I47.1 left the code set in October 2023; use I47.11 or I47.19.
- I49.8 became a non-billable header on October 1, 2026, and I49.81, I49.82, and I49.89 replaced it.
- Words like “routine” or “baseline” in the order read as screening.
- If you expect Medicare to deny the service, get a signed ABN and append GA; our CO-50 medical necessity denials guide covers the appeal path.
Documentation That Holds Up in an Audit
Auditors who pull a 93268 CPT code claim ask for five things: the order, the symptom rationale, proof of attended monitoring, the transmission strips, and the signed interpretation. Miss one, and the payer can recoup a claim you coded right.
- Signed order from the treating physician that names an event monitor and the indication; 42 CFR 410.32 requires the treating physician’s order for diagnostic tests.
- Symptom detail: type, frequency, and the reason you chose event monitoring over a Holter or telemetry; A59268 wants the record to support both monitoring beyond 24 hours and the monitor type.
- FDA-cleared device: UHC’s Medicare Advantage policy covers this monitoring with FDA-cleared devices.
- Attended monitoring proof, plus an emergency notification process; Noridian LCD L40255 requires a way to reach the patient or emergency services for life-threatening arrhythmias.
- Transmission strip elements that A59268 lists: patient name and presenting diagnosis, date and time, channel, PR and QRS intervals when abnormal, rate and rhythm, symptoms or their absence, and actions staff took.
- Signed interpretation that names the interpreting physician.
- Wear start and end dates.
If you aren’t sure your event monitor charts would hold up to a records request, our team can run a medical billing audit and show you which of these seven items are missing before a payer finds them.
Frequency, Units, and Overlap Rules for 93268
One unit of the 93268 CPT code covers one monitoring episode of up to 30 days. If the patient quits on day 12, it’s still one unit. A new episode needs a new order with its own medical necessity, and payers count the days between episodes.
Medicare Rules: One Unit, No Overlapping Monitors
Noridian’s monitoring billing page tells providers to bill ECG monitoring codes in sets and bars completing two sets within 29 days of each other. Its claims system checks Part A and Part B claims nationwide for overlaps, and you can’t appeal those overlap denials.
The new 2026 MAC articles add a patch rule. Noridian article A60279 bars the extended monitoring codes 93241 to 93248 alongside the event monitor components 93270 to 93272 for the same monitoring period. Palmetto and CGS apply the same limit.
Commercial Payer Limits for 93268
Commercial payers set their own windows, and they don’t agree with each other. These rules were in effect on October 1, 2026:
Commercial payer frequency rules for event monitoring
| Payer | Rule | Effect |
|---|---|---|
| UnitedHealthcare | 30-day time-span code (UHC time span policy); components flagged when billed with 93268 in the same 30 days | Resubmit no sooner than day 30 after the prior date of service |
| Medica | 30-day time span on its 2026 list | Same pattern |
| Horizon BCBSNJ and Horizon NJ Health | Once in six months, by any provider (Horizon BCBSNJ policy) | Covers both 93268 to 93272 and 93228 to 93229 |
| Aetna | Repeat study within one year | Goes to medical necessity review |
| Highmark | Use beyond 30 consecutive days | Needs documentation of medical need |
| Fallon Health | No prior authorization for 93268 to 93272 (effective August 1, 2026) | Telemetry still needs prior authorization |
| Blue Cross of Idaho | Plans may require 93268 to avoid unbundling | Prefers the global code |
If you rebill inside one of these windows, expect a frequency denial, and use our CO-151 frequency denials guide to work it.
Which Date of Service Do You Report?
WPS article A57476 sets a date-of-service rule for global Holter claims, the date of physician review, and another for telemetry, the date the patient went on the monitor. For event monitors, the article sets no date rule. Follow your MAC and payer guidance, record both start and end dates, and use one convention across your claims.
UnitedHealthcare measures its 30-day window from the previous date of service, so your date choice moves the next allowed billing date.
Place of Service and Hospital Outpatient Billing
CMS article A56600 lists 93268 and 93270 as Non-OPPS codes, so a hospital outpatient department doesn’t bill them under OPPS. The global code fits a non-facility setting, in most cases POS 11. A hospital-based cardiologist who reads the strips bills 93272 on the professional claim, and our POS 22 billing rules guide covers the outpatient side.
Noridian LCD L40255 doesn’t cover this monitoring for patients in hospitals, emergency rooms, skilled nursing facilities, or other facility-based settings. Palmetto and CGS issued matching “Temporary Nontherapeutic Ambulatory Cardiac Monitoring Devices” LCDs, so read your MAC’s limitation wording before you bill for a patient in a facility.
2026 Medicare Policy Changes for 93268 by MAC
Three MACs put new cardiac monitoring LCDs into effect in June 2026: Noridian on June 21, then Palmetto GBA and CGS on June 28. The FY2027 ICD-10-CM update took effect on October 1, 2026, and it changes how you code several arrhythmias on a 93268 CPT code claim.
Cardiac monitoring policies by Medicare contractor, as of October 1, 2026
| MAC | Jurisdictions and states | LCD | Billing article | 2026 status |
|---|---|---|---|---|
| Noridian | JE (CA, NV, HI, Pacific territories); JF (AK, AZ, ID, MT, ND, OR, SD, UT, WA, WY) | L40255 | Noridian article A60279 | New June 21, 2026; latest LCD version effective August 13, 2026 |
| Palmetto GBA | JJ (AL, GA, TN); JM (NC, SC, VA, WV) | L40257 | A60286 | New June 28, 2026; article revision effective October 1, 2026 |
| CGS | J15 (KY, OH) | L40244 | A60292 | New June 28, 2026 |
| WPS | J5 (IA, KS, MO, NE); J8 (IN, MI) | L34636 | A57476 | In effect; check for the FY2027 diagnosis update |
| Novitas | JH (AR, CO, LA, MS, NM, OK, TX); JL (DE, DC, MD, NJ, PA) | L39490 | A59268 | In effect; check for the FY2027 diagnosis update |
| First Coast | JN (FL, PR, VI) | L39492 | A59270 | In effect since June 11, 2023 |
| NGS | J6, JK | No LCD for ambulatory cardiac monitoring | None | NCD 20.15 applies |
Last verified October 1, 2026.
What Changed on October 1, 2026
Three updates landed around October 1, 2026, and each one can change the outcome of a 93268 claim you send this quarter:
- ICD-10-CM: I49.8 became a non-billable header, and three new codes take its place: I49.81 for Brugada syndrome, I49.82 for ventricular bigeminy, and I49.89 for other specified arrhythmias. I47.22 for CPVT is also new (CMS FY2027 ICD-10 files).
- Fee schedule: CMS posted RVU26D as its October 2026 release of the payment files.
- UnitedHealthcare Medicare Advantage: UHC revised its ambulatory ECG monitoring policy effective September 1, 2026.
93268 Denials: CARC Codes, Causes, and Fixes
Most CPT 93268 denials trace back to four errors: billing the global code next to a component, appending 26 or TC, using a diagnosis outside the LCD, and billing inside a payer’s frequency window. Match the code on your remittance to a row below, then correct the event monitor CPT code line before you resubmit.
Common 93268 CPT code denials and how to fix them
| Denial | Common 93268 trigger | Fix |
|---|---|---|
| CO-97 | Global billed and a component billed for the same episode, by you or another entity | Decide global or components, then void the duplicate |
| CO-4 | 26 or TC appended | Remove the modifier and send a corrected claim |
| CO-50 + N115 (N115 remark code) | Diagnosis or record doesn’t meet the LCD | Appeal with LCD-aligned documentation |
| CO-11 (CO-11 diagnosis mismatch) | Diagnosis inconsistent with the procedure, such as an unlisted code | Corrected claim with the specific diagnosis |
| CO-119 + M86 | Frequency limit hit (Horizon six months, UHC 30 days) | Check claim history; appeal only with a documented new indication |
| CO-18 or OA-18 | Duplicate submission | Void or correct; don’t appeal |
| Noridian overlap edit | Another provider’s monitor overlaps yours | No appeal rights; call Noridian’s Part B provider contact center to find the overlapping provider |
M86 means a payer already paid a same or similar service inside the set time frame. N115 means the payer based its decision on an LCD. Confuse the two, and your team builds the wrong appeal.
If CO-97 and M86 denials on event monitors are sitting in your aging report, our team works them by root cause through our AR follow-up services, starting with who billed what for each monitoring episode.
Frequently Asked Questions About CPT 93268
What is the 93268 CPT code description?
The descriptor for 93268 covers an external event recorder that the patient or the device activates, with a symptom-related memory loop and remote download for up to 30 days. It includes 24-hour attended monitoring, transmission, and the physician’s review and interpretation, so the read sits inside the code.
How long is the monitoring period for CPT code 93268?
The monitoring period for 93268 runs up to 30 days, and the full episode counts as one unit. You still bill one unit when a patient stops wearing the device on day 9. Second episodes need a new order and have to clear each payer’s frequency limit.
What is the difference between 93268 and 93270?
The 93268 CPT code is the global service, and 93270 is one component: the hook-up, recording, and disconnection. One entity bills 93268 for the whole episode. If the work splits, whoever hooks up the patient bills 93270, and nobody bills 93268 for that episode.
Can 93268 and 93272 be billed together?
No, you can’t bill 93268 and 93272 together for the same episode. The physician’s review and interpretation already sit inside 93268, so adding 93272 bills the read twice. Payers deny the pair as bundled, and Blue Shield of California’s policy describes the three components as an unbundling of 93268.
What is the CPT code for a 30-day event monitor?
The right code for a 30-day monitor depends on the device. For a memory-loop event recorder, you bill the 93268 to 93272 family; for mobile cardiac telemetry, 93228 and 93229; for continuous recording longer than 15 days, Category III codes 0937T to 0940T, which have uneven payer coverage.
Is a Holter monitor the same as an event monitor?
A Holter monitor and an event monitor are different devices with different codes. Holter vs. event monitor billing comes down to recording style: a Holter records without a break for up to 48 hours under 93224 to 93227, and an event monitor captures triggered episodes for up to 30 days under 93268 to 93272.
What is the CPT code for event monitor services when an IDTF does the monitoring?
If an IDTF runs the attended monitoring, it bills 93271, plus 93270 when its staff hook up the patient. Your practice bills the pieces it performed, in most cases 93272 for the read, and neither party bills the global 93268 for that episode.
Does Medicare pay 93268 in a hospital outpatient department?
Medicare doesn’t pay 93268 under the hospital outpatient system, because CMS article A56600 lists it as a Non-OPPS code. Hospital-based cardiologists who read event monitor strips bill 93272 on the professional claim, and the 2026 LCDs from Noridian, Palmetto, and CGS exclude facility-based monitoring.
Getting 93268 Claims Paid the First Time
Run this five-point check on each 93268 CPT code claim before it leaves your office, whether you bill the global code or a single component:
- The device on the order matches the event monitor family.
- You know who bills global and who bills components for this episode.
- The claim carries no 26 or TC modifier.
- The diagnosis appears on your MAC’s covered list.
- No other monitor overlaps the episode, and no payer frequency window applies.
If you’d rather have specialists run event monitor claims from charge entry to payment, our team handles coding, claims, denials, and follow-up through our full-service cardiology RCM. Want to see how that works for your practice?
