CPT code 93225 reports the recording part of a Holter study of up to 48 hours: connecting the monitor, the recording period, and disconnecting it. It’s the Holter monitor hook-up code, billed as a technical component only, and Medicare pays $18.04 nationally for it in 2026.
Most practices bill 93225 because they don’t scan their own Holters. Your staff place the monitor, a scanning vendor processes the data, and your cardiologist signs the read. The hook-up line goes wrong in two ways: nobody charges it, or it goes out beside a global 93224 that already pays for it.
93225 is one of four codes in the Holter family, and that family sits inside the wider set of cardiology CPT codes your team bills for monitoring.
Key takeaways for the hook-up line
- 93225 covers connection, recording, and disconnection for up to 48 hours.
- Bill it when your staff hook up the monitor and another entity scans or reads.
- Medicare pays $18.04 nationally in 2026, from 0.54 RVUs.
- CPT 93225 never takes modifier 26 or TC; add modifier 52 under 12 hours.
- Past 48 hours, the hook-up moves to 93242 or 93246.
CPT Code 93225 at a Glance for 2026
Keep this table beside the charge template your staff use for Holter hook-ups. Each row matches a rule that payer edits check before the line pays.
| Item | 2026 detail |
|---|---|
| Code family | 93224 to 93227, external ECG recording up to 48 hours |
| Work covered | Connection, recording, and disconnection |
| Component | Technical component only (CMS PC/TC indicator 3) |
| Total RVUs | 0.54 (work 0.00, practice expense 0.53, malpractice 0.01) |
| 2026 national Medicare rate | $18.04 for most clinicians; about $18.13 for qualifying APM participants |
| Units | One unit per recording of up to 48 hours |
| Modifiers | Modifier 52 when recording runs under 12 hours; never 26 or TC |
| Date of service (WPS) | The date the recording service was performed |
| Same-day reduction | Diagnostic cardiovascular multiple procedure reduction applies |
| Global period | None (XXX) |
| Prior authorization | Not required by Original Medicare; varies by commercial and Medicare Advantage plan |
Sources: CMS 2026 Physician Fee Schedule relative value file; WPS Billing Article A57476, revision R9.
CPT Code 93225 Description: What the Hook-Up Covers
The 93225 CPT code description covers external electrocardiographic recording of up to 48 hours, with continuous rhythm recording and storage. Of that service, 93225 carries only the recording piece: connection, recording, and disconnection.
In plain terms, 93225 is the Holter monitor placement CPT code. It pays for the hands-on hook-up and the hours the device records. Among ambulatory ECG monitoring services, the Holter is the one that stores every beat for scanning later instead of sending data live.
The AMA revised the 93224 to 93227 descriptors effective January 1, 2025, and WPS logged the change in A57476 revision R7. If an older charge template or code lookup still calls the service a 24-hour recording, your staff are working from retired wording.
What the Recording Includes, Step by Step
- Prep the skin and place the electrodes.
- Connect the recorder and start the recording.
- Show the patient how to keep the symptom diary.
- Send the patient home to wear the monitor through daily activity and sleep, for up to 48 hours.
- Remove the monitor and send the stored data for scanning.
Record the hook-up and removal times in the note. On any Holter monitor hook-up code line, those recorded hours decide both the code and the modifier.
What 93225 Doesn’t Pay For
Scanning the stored data and writing the technical report bills as 93226. The physician’s review and signed interpretation bills as 93227. Medicare’s NCD 20.15 adds that the recording device itself isn’t covered as durable medical equipment apart from the diagnostic service.
Other monitors carry their own hook-up codes. An external event monitor uses 93270, which our event monitor hook-up code guide walks through. Mobile cardiac telemetry has no separate hook-up line, because 93229 already includes connecting the patient.
93225 vs 93224, 93226, and 93227
Four Holter codes describe one study of up to 48 hours. 93224 is the global service, and 93225, 93226, and 93227 split it into the hook-up, the scan, and the read. For the global side, see our guide to the Holter monitor CPT code 93224.
| Code | Component | Work covered | 2026 RVUs | 2026 national rate | Usually billed by |
|---|---|---|---|---|---|
| 93224 | Global | Hook-up, scanning, and read | 2.11 | $70.48 | One entity that does all three |
| 93225 | Technical | Connection, recording, and disconnection | 0.54 | $18.04 | Whoever places and removes the monitor |
| 93226 | Technical | Scanning analysis with report | 1.04 | $34.74 | Scanning vendor, IDTF, or in-house tech |
| 93227 | Professional | Physician review and interpretation | 0.53 | $17.70 | Reading physician |
Sources: CMS 2026 Physician Fee Schedule; WPS Billing Article A57476.
The three components add up to 2.11 RVUs, the same as 93224. Bill both for one study and you’re asking the payer to pay for the hook-up twice.
What Is the Difference Between CPT Code 93225 and 93226?
93225 pays for hooking up, recording, and disconnecting the Holter monitor. 93226 pays for scanning the stored data and producing the technical report. Both are technical components, so your practice can bill 93225 while a scanning vendor bills 93226 for the same study. In 2026, Medicare pays $18.04 nationally for the hook-up and $34.74 for the scan.
What Is the Difference Between 93225 and 93227?
93225 is the technical hook-up and recording; 93227 is the physician’s review and signed interpretation, the professional component. Medicare pays $18.04 for 93225 and $17.70 for 93227 in 2026. Each line takes its own date of service: the date the recording was performed for 93225, and the date the interpretation was performed for 93227.
If your cardiologist reads studies that other entities recorded, our guide to the Holter interpretation code 93227 covers that side of the claim.
When to Bill Global 93224 Instead
Bill 93224 alone when one entity performs the hook-up, the scan, and the read. Don’t bill 93224 with 93225 for the same study, because the NCCI procedure-to-procedure edits treat that pair as unbundling.
Before you pick the CPT code for Holter monitor work on a claim, answer three questions from the chart and the vendor contract:
- Did your staff apply and remove the monitor?
- Did your practice scan the data in-house?
- Did your physician read and sign the study?
Three yes answers mean you bill 93224 once. A single no means each entity bills only the piece it performed. Groups that read for several vendors need that map for each payer, and our cardiology billing specialists build it before the first claim goes out.
Who Bills 93225 in Each Setting
The entity that hooks up and removes the monitor bills 93225, unless one entity performs all three parts and bills 93224 instead. The table maps CPT code 93225 across the five setups billing teams see most, so each study shows the hook-up on exactly one claim.
| Setup | Who bills 93225 | Other lines on the study |
|---|---|---|
| Your staff place the monitor, a scanning vendor scans, your physician reads | Your practice | Vendor bills 93226; your practice bills 93227 |
| Your physician hooks up and reads, an IDTF scans | Your practice | IDTF bills 93226; your practice bills 93227 |
| Your practice places, scans in-house, and reads | Nobody separately | Your practice bills 93224 once |
| Hospital outpatient staff place the monitor | The hospital, on its UB-04 facility claim | Your cardiologist bills 93227 only |
| An IDTF places and scans | The IDTF | IDTF bills 93226; global 93224 only under the A57476 employed or contracted physician rule |
Sources: WPS Billing Article A57476; CMS OPPS.
Open the Holter charge template first whenever a 93225 line goes missing from charge entry. A template that lists only the read keeps the hook-up off the claim, and a claim scrubber can’t flag a charge nobody entered.
Vendor-Owned Monitors and the Ownership Question
AAPC’s guidance says a provider must own the equipment to report technical codes, per the AAPC Cardiology Coding Alert from May 13, 2025. A57476 doesn’t address ownership. Treat it as coding guidance and a contract question, since CMS hasn’t written it into a payment rule.
Vendor contracts vary. Some vendors bill every technical line, some bill only the scan, and some invoice your practice instead of the payer. If the vendor and your practice both bill 93225, the second claim to arrive usually denies as a duplicate.
- Read the contract clause that names the CPT codes the vendor submits.
- Get written confirmation of who reports 93225 when the vendor owns the monitor.
- Keep that letter on file for audits.
Hospital Outpatient Departments
If hospital outpatient staff hook up the monitor, the hospital reports the technical work on its UB-04 under the Outpatient Prospective Payment System (OPPS). Your practice can’t also bill 93225 for that study. The cardiologist bills 93227 with POS 22 for an on-campus department or POS 19 for off-campus, and our guide to POS 22 billing rules covers that claim.
Independent Diagnostic Testing Facilities (IDTFs)
An Independent Diagnostic Testing Facility (IDTF) may bill the technical codes. Under A57476, it can bill the complete service only when the interpreting physician is its employee or contractor and doesn’t bill the read separately.
WPS also expects that physician on file with its Provider Enrollment unit through a reassignment, and named in Box 24K of the CMS-1500. NCD 20.15 limits separate physician payment on IDTF EKG services to the patient’s attending or consulting physician.
Medi-Cal and Other Medicaid Rules
The Medi-Cal cardiology manual sets four Holter rules that California practices need to know:
- 93225 isn’t reimbursable when the same provider bills critical care 99291 or 99292 for the same recipient and date.
- The 93224 set, or its components 93225 to 93227, pays once per recipient, per day, across all providers.
- The component total can’t exceed the 93224 rate.
- Split-bill modifiers aren’t reimbursable on 93224.
Other state Medicaid programs set their own Holter rules, so check your state’s provider manual before you bill a split study.
If your cardiologists read for a hospital and a scanning vendor at the same time, mapping who bills which Holter line, payer by payer, is routine setup work for our cardiology revenue cycle management team.
Does CPT 93225 Need a Modifier?
No. CPT 93225 normally goes out with no modifier. The one routine exception is modifier 52 when continuous recording runs under 12 hours, and modifiers 26 and TC never apply.
Base each 93225 modifier choice on the recorded hours and the payer’s edit files. Habits carried over from echo or imaging claims are where wrong modifiers usually start.
Modifier 52 for Recordings Under 12 Hours
The WPS Billing Article A57476 tells providers to append modifier 52 (reduced services) when continuous recording lasts less than 12 hours. The rule covers the whole 93224 to 93227 family, so on a split study the hook-up line and the read both carry 52.
Your chart needs the actual hook-up and removal times. A note saying the patient pulled the device early, with no hours, won’t support the modifier. From 12 to 48 hours, no modifier applies. Past 48 hours, the code itself changes.
MACs differ on how much they reduce a 52 line, so check your remits before you build an expected-payment table around it.
Why Modifier 26 and TC Never Apply
CMS assigns 93225 PC/TC indicator 3, technical component only. CPT already splits the Holter service into separate codes, so 93225 has no professional half to split off. A57476 tells providers not to use TC or 26 with 93224 to 93229 or 93268 to 93272.
The habit comes from echo and imaging, where 26 and TC do split a global code. Carried into a Holter template, either modifier usually draws a CO-4 denial for an invalid modifier. Our guide to where modifier 26 belongs explains which codes take it.
When Modifier 59 or XU Comes Up
Modifier 59 or XU belongs on 93225 only when a current NCCI procedure-to-procedure edit pairs it with a different, separately documented service on the same date. Using 59 to bill 93225 beside 93224 for the same study is unbundling, whatever modifier you add.
CMS updates the procedure-to-procedure tables every quarter, so check the CMS NCCI edit files in effect for your date of service. GA (signed ABN on file) and GZ (no ABN) describe Medicare liability when a service may not be covered; they don’t change the coding.
Recorded Hours, the 48-Hour Limit, and Date of Service
The hours the device recorded, as the scanning report shows them, decide the code and the modifier. Your order’s planned duration doesn’t. CPT code 93225 applies only when the device recorded 48 hours or less, and the 93225 CPT code bills as one unit for that whole period, per A57476.
Which Code the Hook-Up Becomes Past 48 Hours
Searches for a 24-hour Holter monitor CPT code and a CPT code for a 48-hour Holter monitor land in the same family, 93224 to 93227, billed as one unit. Longer recordings move to new codes.
| Recorded time | Global code | Hook-up code | Modifier | 2026 national rate, hook-up line |
|---|---|---|---|---|
| Under 12 hours | 93224 | 93225 | 52 | $18.04 before any reduction |
| 12 to 48 hours | 93224 | 93225 | None | $18.04 |
| More than 48 hours, up to 7 days | 93241 | 93242 | None | $11.69 |
| More than 7 days, up to 15 days | 93245 | 93246 | None | $11.69 |
A 7-day study bills in the 93241 family, and a 14-day study bills in the 93245 family. Sources: AMA CPT descriptors; WPS A57476; CMS 2026 PFS.
Say a 48-hour order comes back with 50 hours on the scanning report. The study bills from the 93241 family, so the hook-up becomes 93242, and the scan and read move with it. A 7-day patch the patient pulled at hour 30 goes the other way and bills in the 93224 to 93227 family.
The extended hook-up codes cover connection and initial recording, while 93225 covers connection, recording, and disconnection. They also pay less: $11.69 against $18.04 in 2026. If your fee schedule assumes a longer study pays more for the hook-up, that gap will show up on your remits.
Coverage tightens as the hours grow. NCD 20.15 asks for documented medical necessity past 24 hours, and Aetna generally treats Holter monitoring past 48 hours as not medically necessary. Our 48-hour Holter billing rules guide covers the global side of that limit.
Which Date Goes on the 93225 Line
Under A57476, the 93225 line takes the date the recording service was performed. 93226 and 93227 also take the date each one was performed. Only global 93224 takes the date of the physician’s review, so don’t carry that review date onto a hook-up line.
A57476 doesn’t say which date to use when a recording spans two calendar days. Using the hook-up date ties the line to the day the service started. If your Holter volume is high, get your MAC’s answer in writing and keep the 93225 date of service consistent across claims.
Picture a Monday hook-up, a Wednesday removal, and a Friday read. Your 93225 line carries Monday and the 93227 line carries Friday. Send both lines out with Friday’s date and the claim no longer matches the chart, which is an easy catch for any reviewer.
Is There a 30-Day Holter Monitor Code?
No Holter monitor CPT code covers 30 days. A 30-day study bills under one of three code sets, depending on the device the physician ordered:
- An external event monitor bills in the 93268 family.
- Mobile cardiac telemetry bills as 93228 for the read and 93229 for the technical work.
- Continuous recording past 15 days, up to 30 days, bills in the Category III 0937T family, where payer coverage varies.
CPT code 93268 is the global code for that first path, and our 30-day event monitor code guide walks through it.
CPT Code 93225 Reimbursement in 2026
Medicare pays $18.04 nationally for 93225 in 2026, or about $18.13 for qualifying APM participants. Hospital outpatient departments are paid separately, and far more, under OPPS. Commercial averages run about 1.7 to 2.2 times the Medicare rate, so 93225 reimbursement in 2026 depends on who’s paying and where the hook-up happened.
How Medicare Calculates $18.04
93225 carries 0.54 total RVUs (0.00 work, 0.53 practice expense, 0.01 malpractice), and 0.54 times the $33.4009 conversion factor gives $18.04. Facility and non-facility amounts match for this code.
Patients pay the 2026 Part B deductible of 283first,perthe**CMS2026PartBfigureshttps://www.cms.gov/newsroom/fact−sheets/2026−medicare−parts−b−premiums−deductibles**.Afterthat,Medicarepays8014.43) and the patient owes 20% ($3.61). The 2% sequestration cut then comes off Medicare’s share, so a fully allowed line deposits about $14.14.
Coinsurance and sequestration explain the gap your team sees between the posted allowed amount and the deposit that lands in the bank.
Locality and Hospital Outpatient Rates
CMS adjusts each physician fee schedule rate by geographic practice cost indices, so the hook-up pays more in high-cost areas. Parts of the San Francisco Bay Area run about $25 for 93225 in 2026. Pull your exact figure from the CMS PFS Look-up Tool before you budget around it.
Hospital outpatient departments sit on a different system. If hospital staff hook up the monitor, the hospital is paid under the Outpatient Prospective Payment System, where 93225 maps to APC 5734 at about $136 nationally in 2026. Check the current quarter’s CMS OPPS Addendum B for your rate.
That OPPS payment covers the hospital’s staff, equipment, and overhead for the visit. Your office’s fee schedule payment covers only the practice expense of the hook-up, which is why the two numbers sit so far apart.
Same-Day Tests and the Multiple Procedure Reduction
Medicare applies a multiple procedure payment reduction to diagnostic cardiovascular services. When the same practitioner or group bills more than one for a patient on the same day, the highest-paid technical component pays in full and each additional one is cut 25%.
93225 is all technical and low-dollar, so it usually takes the cut. Pair a same-day echo with a Holter hook-up and the hook-up pays about $13.53. Your remit shows CARC 59, processed under multiple or concurrent procedure rules. That’s a payment rule, so don’t appeal it.
Commercial Payer Rates
Commercial plans set their own amounts by contract. Published transparency data from August 2026 shows these national averages for 93225:
| Payer | Average allowed | Compared with Medicare |
|---|---|---|
| BCBS | $31.56 | 1.75 times |
| Aetna | $38.08 | 2.11 times |
| Cigna | $38.35 | 2.13 times |
| UnitedHealthcare | $39.07 | 2.17 times |
Average allowed amounts from payers’ published transparency-in-coverage files, August 2026. Your contract rates may differ.
Compare these against your own ERAs for 93225. A contract that pays below Medicare on the hook-up line is worth raising at renewal.
What to Expect for 2027
The CMS CY 2027 proposed rule, released July 14, 2026, sets the non-QP conversion factor at $32.84 (down 1.68%) and the QP factor at $33.17 (down 1.19%). Most of the drop comes from the expiring one-year 2.5% increase.
If 93225 keeps its 0.54 RVUs, it would pay about $17.73, or $17.91 for qualifying APM participants. CMS also proposed practice expense changes, and 0.53 of the 0.54 RVUs on 93225 come from practice expense, so the final number may move. CMS expects to publish the final rule around November 1, 2026.
If you’re not sure every hook-up line is getting charged, or your 93225 deposits don’t match these numbers, a Holter claims audit pulls the last 12 months of 93224 to 93227 lines and checks each one. Our team runs that review.
Medical Necessity, Coverage, and ICD-10 Codes for 93225
Medicare covers Holter monitoring when the record documents signs, symptoms, or another clinical indication, and it doesn’t cover the test as screening. CPT code 93225 needs the same supporting diagnosis as the scan and the read, so a hook-up line without a covered code can deny even when the 93227 line pays.
Are Holter Monitors Covered by Insurance?
Yes, when there’s a documented reason. Under Medicare NCD 20.15, Part B covers ambulatory ECG monitoring for symptoms such as syncope, dizziness, chest pain, palpitations, or shortness of breath, and for checking a patient’s response to antiarrhythmic drug therapy. Screening and routine exams aren’t covered.
Two NCD details catch billers. Monitoring longer than 24 hours needs documented medical necessity, and the recording device isn’t covered separately as durable medical equipment. In 2026, the patient pays the $283 Part B deductible first, then 20% coinsurance. Commercial plans generally cover Holter monitoring when their own policy criteria are met.
ICD-10 Codes WPS Accepts After October 1, 2026
October 1, 2026 change: I49.8 became a category header and is no longer billable. Use I49.81 (Brugada syndrome), I49.82 (ventricular bigeminy), or I49.89 (other specified cardiac arrhythmias). Source: WPS A57476, revision R9.
| ICD-10-CM | Description |
|---|---|
| R00.2 | Palpitations |
| R42 | Dizziness and giddiness |
| R55 | Syncope and collapse |
| I48.0 | Paroxysmal atrial fibrillation |
| I49.81 | Brugada syndrome |
| I49.82 | Ventricular bigeminy |
| I49.89 | Other specified cardiac arrhythmias not elsewhere classified |
Source: WPS Billing Article A57476, revision R9, Group 2. Other MACs publish their own lists.
R00.0 (tachycardia, unspecified) and I49.9 (cardiac arrhythmia, unspecified) aren’t on the WPS Group 2 list, though you’ll see both recommended on code lookup sites. Some commercial payers do accept them; Aetna’s list runs from I49.01 to I49.9. The payer’s own list governs.
For symptom-driven orders, our guide to R00.2 palpitations coding covers what the note needs. Atrial fibrillation orders should carry the most specific type documented, and our AFib ICD-10 codes guide breaks those down.
Commercial Frequency Limits and Prior Authorization
Aetna generally considers Holter monitoring medically necessary no more than twice in six months, under Aetna Clinical Policy Bulletin 0019, reviewed March 13, 2026. It treats monitoring past 48 hours as generally not medically necessary, and its covered list includes pacemaker and ICD function checks (Z95.0 and Z95.810).
Fallon Health requires no prior authorization for 93224 to 93227 under its Fallon Health monitoring criteria, effective August 1, 2026. It does require authorization for 93241 to 93248 and for mobile cardiac telemetry (93228 and 93229).
Original Medicare doesn’t run a prior authorization program for Holter monitoring. Medicare Advantage and commercial plans set their own rules, so check the plan before the hook-up. If your front desk doesn’t have time for that, our eligibility and authorization checks cover it.
Common CPT Code 93225 Denials and How to Fix Them
93225 denials tend to come from four mistakes: a modifier that doesn’t belong, a component billed beside the global code, two entities billing the same hook-up, or a diagnosis the MAC doesn’t accept. Each one leaves a specific code on the remit.
| CARC | What triggered it on 93225 | Fix |
|---|---|---|
| CO-4 | Modifier 26 or TC appended, or 52 used on a recording of 12 hours or more | Remove the modifier, add 52 only under 12 hours, and send a corrected claim. See our CO-4 modifier denials guide. |
| CO-97 | 93225 billed with 93224 for the same study, or with another ECG monitoring code for the same period | Keep one structure: the global code alone, or only the components you performed. See CO-97 bundling denials. |
| OA-18 | Vendor and practice both billed 93225, or a correction went out as a new claim | Confirm the vendor contract, void the duplicate, and send corrections with frequency code 7. See OA-18 duplicate claims. |
| CO-11 | Diagnosis not on the MAC’s list, such as R00.0, I49.9, or I49.8 after October 1, 2026 | Recode from the chart to a covered code; if the chart has none, coding can’t fix it. See CO-11 diagnosis mismatch. |
| CO-50 | No documented symptom, a screening order, or monitoring past 24 hours without documented need | Appeal only when the record supports it, and use an ABN when you expect non-coverage. |
CARC definitions per the X12 code list; rules per WPS A57476 and NCD 20.15.
Three related cases don’t need an appeal:
- A 93225 line billed for a recording longer than 48 hours sits in the wrong code family, so recode it to 93242 and move the scan and read with it.
- CARC 59 on a 93225 line is the multiple procedure reduction, a payment rule you can leave alone.
- Medi-Cal won’t pay 93225 when the same provider bills 99291 or 99292 for that recipient on the same date.
Compare a denied hook-up line against the scanning report first. The recorded hours on that report settle the modifier, the code family, and the date question in one look.
If the same Holter denials keep coming back each month, the fix usually sits upstream, in the charge template. That root-cause work is what our denial management services team does every day.
Documentation Checklist for the 93225 Hook-Up Line
A 93225 line holds up in review when the chart shows who placed the monitor, when, for how long, and why. Keep these seven items in the record:
- Get a signed order from the treating physician that names the symptom or indication.
- Record the symptom and how often it happens, since frequency supports a 48-hour study over a longer monitor.
- Note the hook-up date, the time, and the staff member who placed the monitor.
- Note the removal time and the total recorded hours from the scanning report, with the reason if under 12 hours.
- Document that the patient received diary instructions.
- Record who owns the device and who performs the scan.
- Check the ICD-10 code against your MAC’s list for the date of service, and get an ABN when coverage is doubtful.
Items 3 and 4 decide the code and the modifier, so they’re the two worth building into your EHR template first.
93225 Myths vs Facts
Several pages that rank for 93225 repeat rules that don’t match CMS guidance, and the table sets each claim against its source.
| Myth | Fact |
|---|---|
| 93225 takes modifier TC because it’s a technical service | 93225 is already technical only, and A57476 bars 26 and TC on 93224 to 93229. |
| Modifier 59 lets you bill 93225 with 93224 | 93224 already includes the hook-up, so billing both for one study is unbundling. |
| 93225 covers 7-day or 30-day monitoring | 93225 covers up to 48 hours; past that, the hook-up bills as 93242 or 93246. |
| 93228 and 93229 are extended Holter codes | 93228 and 93229 are mobile cardiac telemetry codes for up to 30 days of attended monitoring. |
| The 93225 line uses the physician’s review date | 93225 uses the date the recording was performed; the review date belongs to global 93224. |
| R00.0 and I49.9 support 93225 with every payer | Neither code is on the WPS Group 2 list, and each payer’s own list governs. |
| The office rate for 93225 is higher than the facility rate | 93225 pays $18.04 in both settings on the 2026 physician fee schedule. |
Sources: WPS A57476, revision R9; CMS 2026 Physician Fee Schedule; NCCI.
CPT 93225 FAQs
What Is CPT Code 93225 Used For?
93225 reports the recording part of a Holter study of up to 48 hours: connecting the monitor, the recording period, and disconnecting it. Practices bill it when their staff place the monitor and another entity handles the scan or the read. When one entity does all three, it bills 93224 instead.
How Much Does the 93225 CPT Code Pay in 2026?
Medicare’s 2026 national rate for 93225 is $18.04, from 0.54 RVUs times the $33.4009 conversion factor, or about $18.13 for qualifying APM participants. High-cost localities pay more. Hospital outpatient departments are paid separately under OPPS, at about $136 nationally, and commercial averages run roughly $31 to $39.
What Is the CPT Code for Holter Monitor Placement?
Holter monitor placement bills as 93225 when the recording lasts 48 hours or less. The code covers connection, recording, and disconnection. If the recording runs past 48 hours, placement moves to 93242 for more than 48 hours up to 7 days, or 93246 for more than 7 days up to 15 days.
Can 93224 and 93225 Be Billed Together?
No, not for the same study. 93224 is the global Holter code and already includes the hook-up, so adding 93225 bills the recording twice and draws an NCCI bundling denial. Bill 93224 alone when one entity does everything, or bill only the components each entity performed.
What’s the Difference Between an ECG and a Holter Monitor?
A standard 12-lead ECG captures the heart’s rhythm for a few seconds in the office, and it bills as 93000 when one provider performs and interprets it. Our 12-lead EKG code 93000 guide covers that claim. A Holter monitor records every beat for up to 48 hours and bills as 93224, or as 93225, 93226, and 93227.
Is 93225 Still a Valid Code for 2027?
93225 is active for 2026. Before January 1, 2027, check two places: the AMA’s CPT 2027 code set for any descriptor change, and the CY 2027 final rule, expected around November 1, 2026. Under the proposed 2027 conversion factor, the code’s 0.54 RVUs would pay about $17.73.
Getting the Hook-Up Line Paid the First Time
Before any Holter monitor hook-up code leaves the building, have your staff answer three questions:
- Who did each part of the study?
- How many hours did the device record?
- Is the diagnosis on the MAC’s list for that date?
Those three checks catch modifier, code-family, and diagnosis errors on CPT code 93225 before a payer sees them.
One O Seven RCM handles Holter coding for cardiology practices whose studies are split between their own staff, scanning vendors, and hospitals. If you’d like that work folded into end-to-end cardiology RCM, we’re happy to look at how your setup runs today.
