The 93226 CPT code reports the scanning analysis with report for an external Holter recording of up to 48 hours. A technician runs the stored ECG data through scanning software and writes that report. Hook-up bills as 93225, and the physician’s read bills as 93227.
For 2026 dates of service, 93226 is active and pays a $34.74 national rate for non-QP clinicians. Its 1.04 RVUs make it the largest of the three Holter components. It’s also the piece practices hand to outside scanning services, which is how two entities end up billing one scan.
Your other Holter lines have their own pages. The 93224 global Holter guide covers the full study when one provider does everything. For the physician’s read, use the 93227 interpretation guide.
| Field | 2026 detail |
| Code | 93226 |
| Descriptor (AMA CPT) | External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report |
| CMS short descriptor | Xtrnl ecg rec<48 hr scan a/r |
| Component | Technical only (PC/TC indicator 3) |
| Work RVU / total RVUs | 0.00 / 1.04 (facility and non-facility) |
| 2026 national rate | $34.74 non-QP; $34.91 QP |
| Units | One per recording period of up to 48 hours |
| Modifiers | None on a standard study; 52 under 12 hours; 26 and TC are barred |
| Date of service | Date the scanning analysis was performed |
| Status | Active in 2026; no Holter changes in the CPT 2027 headline updates |
What Is CPT Code 93226?
93226 is the technical scanning step of a Holter study: the work done after the patient returns the monitor and before the physician reads it. Medicare’s payment for it covers technician time and the scanning equipment, with no physician work built in.
Picture a Tuesday morning. A patient drops the monitor off at your front desk, and your technician downloads up to 48 hours of stored rhythm data. Scanning software flags pauses, tachycardia runs, and ectopic beats. Your tech confirms or corrects each flag and matches it to the patient’s diary.
Ambulatory ECG monitoring stores up to two full days of heartbeats. The scan works like an edited highlight reel, and the physician’s read is the review of that reel. Scan and read are separate jobs, often done by different people, so each job gets a separate code.
Inside the 93226 Scanning Report
A complete scanning report hands the reading physician five things:
- Heart rate trends
- Arrhythmia counts
- Pause and run summaries
- Representative strips
- Diary correlation
That report is the deliverable CPT 93226 pays for. If your chart has no scanning report, the claim has nothing behind it when a payer asks for records.
PC/TC Indicator 3: Why CMS Treats 93226 as a Technical Code
CMS assigns 93226 PC/TC indicator 3, which means it’s a technical component code with no professional portion. Its 1.04 total RVUs break down to 0.00 work, 1.03 practice expense, and 0.01 malpractice in the CMS physician fee schedule RVU files.
The practice expense inputs behind that value are an electrodiagnostic technologist’s time and a Holter analysis system. With zero physician work in the value, nothing about the read belongs on this line. Our guide to modifier 26 and PC/TC rules covers how the indicators split payment.
Some fee schedule sites describe 93226 as an office visit with moderate medical decision making. That description doesn’t fit a scanning service. Build a charge template from it, and you’ll be looking for documentation the scan doesn’t produce.
93226 CPT Code Description: Official and CMS Short Descriptor
The official descriptor reads: “External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report.” That wording comes from the AMA. Payers quote it in 2026 policies, including the UnitedHealthcare Medicare Advantage ECG monitoring policy effective September 1, 2026.
| Version | Text | Where you’ll see it |
| AMA CPT descriptor | External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage; scanning analysis with report | CPT codebook, payer policies |
| CMS short descriptor | Xtrnl ecg rec<48 hr scan a/r | Fee schedule files, PFS Look-up Tool, remittances |
| Plain English | The technician’s scan and written report of a Holter recording of up to 48 hours | Your charge master description |
WPS logged descriptor changes to 93224, 93225, 93226, and 93227 in Billing Article A57476 revision R7, effective January 1, 2025. Some lookup sites still carry the older wording. If your charge master description predates 2025, update it so your claims and your policy files match.
At least one code lookup site describes 93226 as covering “more than 48 hours up to 21 days.” That wording belongs to 0297T, a Category III code the AMA retired on January 1, 2021. WPS recorded the swap to 93241 to 93248 in A57476 revision R2.
93226 and the Other Holter Monitor CPT Codes
93226 is one of four Holter codes, all limited to recordings of up to 48 hours. The global service is 93224, and 93225, 93226, and 93227 split it into hook-up, scan, and read. You’ll find the wider set in our cardiology CPT codes hub.
| Code | Component | What it covers | PC/TC | 2026 RVUs |
| 93224 | Global | Recording, scanning analysis with report, review and interpretation | 4 | 2.11 |
| 93225 | Technical (recording) | Connection, recording, and disconnection | 3 | 0.54 |
| 93226 | Technical (scanning) | Scanning analysis with report | 3 | 1.04 |
| 93227 | Professional | Review and interpretation by a physician or QHP | 2 | 0.53 |
Add the three components and you get 2.11 RVUs, the same as the global code. Splitting a study moves payment between entities, and Medicare’s total stays put. Scanning carries about 49% of that value, which is why a lost 93226 line hurts more than a lost hook-up.
Recording length doesn’t change the code inside that window. The CPT code for 24 hour Holter monitor studies matches the CPT code for 48 hour Holter monitor studies. Your Holter monitoring CPT code set stays the same whether the patient wore the monitor one day or two.
Billing 93224 next to any of its components for the same study is a bundling error. A57476 bars billing other EKG monitoring codes with 93224 to 93227. The 93224 CPT code description already includes the scan. Our Holter monitor CPT code guide for 93224 walks through billing that global line.
CPT 93225 vs 93226: What’s the Difference?
93225 is the hook-up and recording; 93226 is the scan of that recording and its written report. Both are technical component codes. They often happen on different days, and different entities can perform them.
| Detail | CPT 93225 | 93226 |
| What it covers | Connection, recording, disconnection | Scanning analysis with report |
| Who bills it | The entity that applies and removes the monitor | The entity that runs the scan (in-house tech, scanning service, IDTF) |
| Date of service (WPS) | Date performed | Date the scan was performed |
| 2026 RVUs / national rate | 0.54 / $18.04 | 1.04 / $34.74 |
| PC/TC indicator | 3 | 3 |
The 93225 CPT code description covers connection, recording, and disconnection. If your practice hooks up the monitor and ships the data out for scanning, you bill 93225 and stop there for technical work. A dedicated 93225 guide is on our publishing list.
93226 vs 93227: Scan or Read?
93226 is the technician’s scanning report; 93227 is the physician’s signed interpretation of it. The 93227 CPT code description covers review and interpretation by a physician or other qualified health care professional, and our CPT 93227 billing rules walk through that line.
Some charge templates swap the two. Bill 93226 for a physician read, and the line won’t match the service in the chart. Put 93227 on vendor scanning, and you’ve billed work your physician didn’t do. Compare each template code against who signed what.
Pairing 93226 and 93227 works as long as 93224 isn’t on any claim for that study. A practice that scans in-house and reads, while a hospital or vendor handles the hook-up, bills both lines.
Who Bills CPT 93226? Practice, Vendor, IDTF, and Hospital Setups
The entity that performed the scanning analysis bills 93226, as long as no claim carries the global 93224 for that study. Performing the scan decides ownership of the line, whether your technician or a vendor’s technician ran it. The reading physician bills the read, and the hook-up has its own code.
| Setup | Who bills 93226 | Other lines |
| Practice owns the monitor, scans in-house, and reads | Not on its own; the practice bills 93224 once | None |
| Practice hooks up and reads; outside service scans and bills the payer | The scanning service | Practice bills 93225 and 93227 |
| Practice hooks up and reads; service scans and invoices the practice | The practice, as a purchased test | Practice bills 93225, 93226, and 93227 |
| Hospital outpatient department records and scans | The hospital, on its facility claim | Reading physician bills 93227 |
| IDTF performs the technical work | The IDTF under its own enrollment | Follows the WPS IDTF rules |
Your Practice Does Everything: Bill 93224 Once
If you own the monitor, scan in-house, and read, bill 93224 once. AAPC guidance says that to report global codes, “the provider must own the equipment,” per the AAPC Cardiology Coding Alert on wearables from May 13, 2025.
In practice, the template error to watch for is a 93226 line sitting next to the global 93224. Payers treat that pairing as unbundling and send it back as a CO-97 bundling denial. Strip the component line before the claim leaves your system.
Outside Scanning Services: Two Billing Models
An outside scanning service works one of two ways. It bills the payer for the scan itself, or it invoices your practice and you bill the scan as a purchased test. Your vendor contract decides which model you’re in, so read it before you build the charge template.
Ask the vendor for its monthly report of 93226 claims and match it against your own charges. A shared patient and date on both lists means one of you has to void. Billing the 93226 CPT code for a purchased scan can also bring in Medicare’s anti-markup rule, 42 CFR 414.50.
IDTF Billing Rules for CPT Code 93226
Under WPS Billing Article A57476, an IDTF may bill the technical Holter codes. It can bill the global code only if the interpreting physician is its employee or contractor and doesn’t bill the read on its own claim. WPS Provider Enrollment must hold that physician’s name, address, and reassignment letter.
Without the reassignment letter, WPS denies the professional services the IDTF billed. The claim lists the interpreting physician’s sequence number in Box 24K. Each supervising physician can give general supervision to no more than three IDTF sites under 42 CFR 410.33(b)(1).
The NCD 20.15 Electrocardiographic Services policy adds a national limit: Medicare covers separate physician services for IDTF EKG tests only if the physician is the patient’s attending or consulting physician. WPS sets the reassignment and Box 24K rules. Other MACs publish separate IDTF articles, and the full WPS text is in WPS Billing Article A57476.
Hospital Outpatient Billing for 93226
A hospital outpatient department reports the recording and the scan on its facility claim (UB-04). The cardiologist bills 93227 alone on the CMS-1500, with POS 22 for an on-campus outpatient department or POS 19 for off-campus. Our POS 22 billing rules cover the place-of-service details.
Observation status doesn’t change that split. The physician still bills the read and nothing more, and the facility side stays with the hospital’s billing office or its hospital revenue cycle support partner.
If your Holter studies split across a scanning vendor, a hospital, and your reading physicians, each line on each claim needs a clear owner. Our cardiology billing services team maps that before claims go out.
Purchased Holter Scans and the Medicare Anti-Markup Limit
If your practice orders a Holter study, buys the scan from an outside supplier, and bills CPT 93226 itself, Medicare’s anti-markup rule may cap what you’re paid. Practices that buy scans at a flat price per study and bill the fee schedule rate carry the most exposure.
Under 42 CFR 414.50, the cap applies to a technical component your practice ordered and an outside supplier performed. Your practice escapes the cap if the supplier shares your practice, and the regulation gives two tests for that.
Under the first test, the performing physician furnishes at least 75% of their professional services through your practice. The second covers a performing physician who is your owner, employee, or contractor and performs the test in your office. Meet either test, and the anti-markup cap stays off the claim.
If the cap applies, Medicare limits payment to the lowest of these amounts:
- The supplier’s net charge to your practice
- Your practice’s actual charge
- The fee schedule amount the supplier would have been allowed
Say a vendor invoices you $22 per scan, an illustrative figure. Medicare’s allowed amount for that 93226 CPT code line caps at $22, even though the fee schedule shows $34.74. Leave the purchase price off the claim, and a later review can treat the difference as an overpayment.
That’s why the cleaner setup lets the vendor bill the payer for 93226. Your practice keeps 93225 and 93227, and the anti-markup rule has nothing to cap. Commercial contracts vary on purchased services, so check each contract’s language before you pick a model.
Reporting a Purchased Scan on the CMS-1500
The CMS MLN CMS-1500 claim fields lesson sets out four steps for a test under the anti-markup limit:
- Mark Item 20 (Outside Lab?) “Yes.”
- Enter the acquisition price under charges.
- Complete Item 32 with the service facility location.
- Submit each anti-markup test on its own paper CMS-1500. An 837P can carry several if each line has the right facility details.
Our CMS-1500 field guide covers each box in order. Keep the vendor invoice filed with the study so the purchase price is next to the claim if a reviewer asks for it.
If you buy scans from a vendor, comparing each invoice against the Medicare remittance shows whether the cap is trimming payments or setting up a recoupment. Our cardiology billing audit runs that comparison claim by claim.
Does CPT 93226 Need a Modifier?
No. 93226 goes out with no modifier on a standard study. WPS Billing Article A57476 rules out 26 and TC for 93224 to 93229, along with 93268, 93270, 93271, and 93272.
The issue is that 93226 already is the technical component (PC/TC indicator 3), so there’s nothing left to split. A TC on the line repeats what the code says, and a 26 claims professional work the 93226 CPT code doesn’t include. Both tend to come back as CO-4 modifier denials.
Modifier 52 belongs on the line if continuous recording ran less than 12 hours, per A57476. The rule covers the scan along with the hook-up and the read. Pull the hook-up and removal times from the device log first; a note saying “patient removed early” with no hours won’t support 52.
Liability modifiers come up in ABN situations:
- GA when a signed ABN is on file
- GZ when the provider expects a medical necessity denial and has no ABN
- GY for a service Medicare excludes by statute, such as a screening Holter
Modifier 59 or XU belongs on 93226 if a current NCCI PTP edit pairs it with another code on the claim and the chart supports a distinct service. CMS posts those pairs in its NCCI procedure-to-procedure edits, and the Q4 2026 files took effect October 1, 2026.
Several code lookup pages and AI search answers still list these modifiers for 93226.
93226 modifier myths and the rule that applies
| Myth | Fact | Source |
| Modifier 26 or TC applies to 93226 | No. A57476 bars both on 93224 to 93229 | WPS A57476 |
| Modifier 91 covers a repeat Holter scan | 91 is the repeat clinical lab test modifier, and it doesn’t apply to Holter scanning | CPT modifier definitions |
| Modifier 76 or 77 handles a second study in the same window | One unit covers up to 48 hours, and overlap rules block a second set in most cases | WPS A57476; Noridian |
| Modifier 52 applies to anything under 48 hours | Modifier 52 applies to recordings under 12 hours | WPS A57476 |
| Modifier 59 is routine on Holter claims | It needs a current NCCI PTP edit and a distinct service in the chart | CMS NCCI PTP, Q4 2026 |
Date of Service, Units, and Overlap Rules for 93226
If you bill 93226 on its own, the date of service is the date the scanning analysis took place, per WPS Billing Article A57476. The global 93224 takes a different date. For the global code, A57476 uses the date of the physician’s review.
| Code | Date of service under WPS A57476 |
| 93224 (global) | Date of physician review |
| 93225 (recording) | Date performed |
| 93226 (scanning) | Date performed |
| 93227 (read) | Date performed |
Take a split study. Your medical assistant hooks the patient up Monday, the technician scans Wednesday, and the physician reads Friday. That claim carries three different dates in Item 24A, which is correct. Putting all three lines on the hook-up date reports the scan and the read on a day neither happened.
You bill the 93226 CPT code at one unit per recording period of up to 48 hours (A57476). A second scanning pass or a preliminary report doesn’t create a second unit, and a claim with two units can draw a duplicate denial.
Three overlap rules stop Medicare from paying for two forms of ambulatory cardiac monitoring on the same days:
- A57476: providers can’t bill other EKG monitoring codes at the same time as 93224 to 93227.
- A57476: for the same dates of service, Medicare covers the wearable patient monitor or the Holter monitor (up to 48 hours), not both.
- Noridian electrocardiographic monitoring billing guidance for Jurisdiction F: providers bill monitoring codes in sets, providers can’t complete sets within 29 days of each other, the claims system reviews Part A and Part B claims nationwide for overlaps, and these denials carry no appeal rights.
Other MACs publish separate overlap guidance. Noridian says overlap questions rank among the top inquiries at its Provider Contact Center. Before hook-up, check the patient’s last 30 days for any patch, event monitor, or MCT claim, including claims other providers billed.
Recordings Past 48 Hours: The Scanning Code in Each Monitoring Family
CPT code 93226 stops at 48 hours of recorded data. Past that point, the study moves to a different code family with its own scanning code. The recorded hours on the scanning report decide the code, whatever wear time the order planned.
The technical scan or analysis code in each monitoring family
| Family | Recorded duration | Global | Technical scan or analysis | Read |
| Holter | Up to 48 hours | 93224 | 93226 | 93227 |
| Extended continuous | More than 48 hours up to seven days | 93241 | 93243 | 93244 |
| Extended continuous | More than seven days up to 15 days | 93245 | 93247 | 93248 |
| Extended continuous (Category III) | More than 15 days up to 30 days | 0937T | 0939T | 0940T |
| Event monitor (memory loop) | Up to 30 days | 93268 | CPT 93271 (transmission and analysis) | 93272 |
| Mobile cardiac telemetry | Up to 30 days | None | 93229 (technical support) | 93228 |
The 93243 CPT code description and the 93247 CPT code description both end in “scanning analysis with report,” the same piece 93226 covers for shorter studies. CPT 93243 handles more than 48 hours up to seven days, and CPT 93247 picks up from there to 15 days.
Searches for a 7 day Holter monitor CPT code or a 14 day Holter monitor CPT code are about patch monitors. A patch worn a week that records 50 hours lands in 93241 to 93244; a patch that records more than seven days lands in 93245 to 93248. Coverage for 0937T to 0940T varies by payer.
Both extended Holter monitor CPT code families keep the global, scan, and read split you know from the Holter set. Memory loop recorders belong to the event monitor family, and our event monitor CPT code guide for 93268 covers that family.
Robin Peterson, CPC, CPMA, quoted in the April 28, 2023, AAPC Cardiology Coding Alert on Holter claims, says the analysis time on the actual scanning report confirms which code applies. Vendor spreadsheets of billed monitors help you spot errors, but the report settles the code.
A57476 adds a WPS limit for the extended codes. Medicare doesn’t cover 93241 to 93248 for inpatient or outpatient observation care, and providers can’t bill other EKG monitoring codes alongside them.
CPT 93226 Reimbursement Rates in 2026, and What to Expect in 2027
93226 carries 1.04 total RVUs in 2026, all practice expense and malpractice, with 0.00 work RVUs. At the $33.4009 non-QP conversion factor, the national rate is $34.74. Qualifying APM participants (QPs) get $34.91 at $33.5675, and the facility and non-facility RVUs match.
| Code | 2026 total RVUs | 2026 national, non-QP | 2026 national, QP |
| 93224 | 2.11 | $70.48 | $70.83 |
| 93225 | 0.54 | $18.04 | $18.13 |
| 93226 | 1.04 | $34.74 | $34.91 |
| 93227 | 0.53 | $17.70 | $17.79 |
Your own payment for the 93226 CPT code runs RVUs times your locality GPCI times the conversion factor, so it will differ from the national figure in most localities. Check your locality in the CMS PFS Look-up Tool. Medicare pays 80% of the allowed amount after the Part B deductible.
Before you update a fee schedule, load values from the current CMS RVU file. Your charge master should list 93226 as its own priced line. Keeping that price current each January, alongside 93224, 93225, and 93227, is routine work in cardiology revenue cycle management.
The CMS CY 2027 PFS proposed rule fact sheet, released July 14, 2026, proposes a non-QP conversion factor of $32.8409, down 1.68%. For QPs, the factor drops 1.19% to $33.1693. Most of that drop comes from the end of the 2.5% increase Congress set for 2026 alone.
If 93226 keeps 1.04 RVUs, the 2027 national rate would land at an estimated $34.15 for non-QP clinicians and an estimated $34.50 for QPs. Treat both figures as estimates until CMS publishes the final rule, which hadn’t come out as of October 23, 2026.
Is 93226 Still Valid in 2027?
Yes, based on the AMA’s September 2026 release. The AMA CPT 2027 code set release lists 453 editorial changes: 299 new codes, 74 revisions, and 80 deletions. Its headline areas are maternity care, ventricular assist devices, hernia repair, prostate biopsy, biofeedback, radiology, and sleep medicine.
Holter codes aren’t on that list. Confirm 93224 to 93227 in your 2027 codebook before you bill January 2027 dates of service, since the headline list doesn’t name each revised code.
Medical Necessity and Diagnosis Codes for 93226 After October 1, 2026
93226 pays when the chart supports a diagnostic reason for the Holter study. NCD 20.15 covers EKG services as diagnostic tests for documented signs and symptoms, and it excludes screening and routine exams. Monitoring longer than 24 hours also needs documented medical necessity under the NCD.
WPS lists the supporting diagnoses in Group 2 of Billing Article A57476, which pairs with LCD L34636. These examples support the 93226 CPT code under WPS. Check the full list in the article before you set up a charge template.
| Category | Example covered codes (A57476 R9, Group 2) |
| Symptoms | R00.1, R00.2, R06.02, R07.9, R42, R55 |
| Arrhythmias | I47.10, I47.19, I48.0, I48.91, I49.1, I49.3, I49.5 |
| October 1, 2026 additions | I49.81 Brugada syndrome, I49.82 ventricular bigeminy, I49.89 other specified cardiac arrhythmias |
| TIA and stroke history | G45.9, Z86.73 |
Palpitations sit on that symptom list as R00.2. Our R00.2 palpitations coding guide covers the chart documentation that supports the code when a payer asks for records.
A57476 revision R9, effective October 1, 2026, deleted I49.8 and added I49.81, I49.82, and I49.89 to match the FY2027 ICD-10-CM update. I49.8 is now a category header, and payers won’t accept it for dates of service from October 1, 2026, on. Update superbill favorites and charge templates now.
R00.0 (tachycardia, unspecified) and I49.9 (cardiac arrhythmia, unspecified) are valid codes, but neither appears on the WPS Group 2 list. I47.1 has been a category header since October 1, 2023. Older cheat sheets still list all three, and commercial payer lists differ.
Commercial plans add frequency limits for ambulatory ECG monitoring. Aetna’s Clinical Policy Bulletin 0019, reviewed March 13, 2026, sets a general limit of two Holter studies in six months. It also treats Holter monitoring past 48 hours as not medically necessary in most cases.
Original Medicare doesn’t run a prior authorization program for Holter studies. Medicare Advantage and commercial plans can require it, so build eligibility and prior authorization checks into scheduling, before the patient leaves with the monitor.
Common 93226 Denials and How to Fix Them
93226 denials fall into three groups: ownership errors, where two entities bill one scan or a global code lands beside a component, plus modifier errors and diagnosis errors.
| CARC | What happened on the 93226 line | Fix |
| CO-97 | 93224 billed for the same study as 93226 | Decide global or components, then void the extra line |
| OA-18 | Practice and scanning vendor both billed 93226; see OA-18 duplicate claims | Confirm who performed the scan; the other entity voids its claim |
| CO-4 | 93226 billed with TC or 26, or without 52 on a recording under 12 hours | Correct the modifier and send a corrected claim |
| CO-11 or CO-50 | 93226 diagnosis off the MAC list, such as R00.0 or I49.9 under WPS; see CO-11 diagnosis mismatch | Recode from the order and recheck the list |
| CO-16 | Often a purchased 93226 scan missing the Item 20 price or the Item 32 location | Add the missing items and resubmit |
| Overlap denial (code varies by MAC) | Another monitor billed for the same period as 93226 | Check the patient’s recent monitoring claims before hook-up |
This is where the OA-18 row gets specific to scanning. Contracts switch from “vendor bills” to “practice purchases,” and charge templates lag behind the paperwork. Pull 90 days of 93226 lines and match them against vendor invoices.
If the same CARC keeps coming back on your Holter lines, the fix belongs in the charge template. Our denial management team traces repeat denials back to the step that caused them.
Chart Documentation for a Payable 93226 Claim
A payer reviewing a 93226 line asks for the scanning report first, then for proof of who performed it. Keep these seven items with each CPT code 93226 claim, and you’ll have the answer to both requests on hand:
- Signed order from the treating physician with the indication (42 CFR 410.32, cited in A57476)
- Symptoms and how often they occur
- Hook-up and removal times, with total hours recorded
- Dated scanning report naming the entity that ran the scan
- Patient diary matched to the flagged events
- Vendor agreement showing who scans and who bills
- Purchase invoice, when the practice bought the scan
Item four does the most work in an audit. A scanning report that names your vendor, sitting next to a claim that bills 93226 as your own service, is the first mismatch a reviewer spots.
CPT 93226 FAQs
Is 93226 the Holter interpretation code?
No. The 93226 CPT code description ends with “scanning analysis with report,” which is the technician’s scan of the recording. Your physician’s signed interpretation bills as 93227, under the reading physician’s name.
On the claim, the 93227 line carries the reading physician as rendering provider, and the 93226 line carries whoever performed the scan. If a vendor scanned, the 93226 line belongs on the vendor’s claim or on yours as a purchased test. Check both fields before your next Holter batch.
Is CPT 93228 a Holter monitor code?
No. 93228 is the physician review and interpretation for mobile cardiac telemetry, which sends data to an attended surveillance center for up to 30 days. Holter data runs up to 48 hours, and a technician scans it afterward under 93226.
The 93228 CPT code description covers the physician’s read, and A57476 adds the billing rule: providers bill 93228 and 93229 once per course of up to 30 days. Its date of service is the day the patient went on the monitor.
Can 93226 be billed with 93229 for the same period?
No, not for the same monitoring period. The 93229 CPT code description covers technical support for mobile cardiac telemetry, a separate monitoring family. A57476 bars billing other EKG monitoring codes alongside 93224 to 93227.
For the same dates, Medicare covers the wearable monitor or the Holter monitor, not both. Pick one family for the period, and make sure the order and the claim name the same one, down to the dates. A mismatch between the two invites a records request.
Is there a CPT code for a 30-day Holter monitor?
No. Holter codes stop at 48 hours. If you’re looking up a CPT code for Holter monitor 30 days, you need a different code family, and the device your practice uses determines which one.
A continuous recording of 30 days bills as Category III 0937T to 0940T, with 0939T for the scan. Event monitors use 93268 to 93272, and mobile telemetry uses 93228 and 93229. Check the payer’s policy on the Category III codes before the patient leaves with the device.
Are Holter monitors covered by insurance?
Yes, when a treating physician orders the study for documented symptoms or a suspected arrhythmia. Medicare doesn’t cover screening Holters under NCD 20.15, and commercial plans add their own limits, such as Aetna’s guideline of two studies in six months.
Patient cost follows the usual Part B math. The 2026 Part B deductible is $283, per the CMS 2026 Medicare Part B premiums and deductibles fact sheet. After that, the patient owes 20% of the Medicare-approved amount in most cases.
Is the 93226 CPT code still valid in 2027?
Yes. The headline changes in the AMA’s CPT 2027 release don’t touch the Holter family, so 93226 carries into 2027 as far as the published list shows.
Rates are a separate question. CMS’s CY 2027 PFS proposed rule would lower the non-QP conversion factor to $32.8409, which puts 93226 at an estimated $34.15 if its 1.04 RVUs hold. Confirm the code and the rate in the final rule and the 2027 codebook before you bill January dates of service.
Getting the Scanning Line Paid the First Time
Each 93226 CPT code claim comes down to who ran the scan and whether anyone else billed it. If your technician ran it, check for a 93224 on the same study. For a vendor scan, confirm whether the vendor bills the payer or invoices you.
For practices whose Holter studies split across vendors, hospitals, and reading physicians, a claim-level Holter audit from One O Seven RCM can surface the duplicates and anti-markup gaps. A sample of recent 93226 lines is enough to show whether the problem lies in a template or a contract.
Sources
- WPS Billing Article A57476, Electrocardiographic Monitoring, revision R9
- NCD 20.15 Electrocardiographic Services
- 42 CFR 414.50, physician or other supplier billing for diagnostic tests
- 42 CFR 410.33, independent diagnostic testing facility
- CMS MLN CMS-1500 claim fields lesson
- CMS PFS relative value files
- CMS CY 2026 PFS final rule fact sheet
- CMS CY 2027 PFS proposed rule fact sheet
- CMS PFS Look-up Tool
- CMS NCCI procedure-to-procedure edits
- CMS 2026 Medicare Part B premiums and deductibles
- AMA CPT 2027 code set release
- Noridian JF electrocardiographic monitoring billing
- UnitedHealthcare Medicare Advantage ambulatory ECG monitoring policy
- Aetna Clinical Policy Bulletin 0019, Holter monitors
- AAPC Cardiology Coding Alert: Navigate Tricky Holter Monitoring Claims With Ease
- AAPC Cardiology Coding Alert: coding cardiovascular wearables
CPT is a registered trademark of the American Medical Association. CPT codes and descriptions are copyright American Medical Association. Rates are 2026 Medicare national figures from the CMS Physician Fee Schedule. Date-of-service, modifier, and diagnosis rules come from WPS Billing Article A57476 revision R9. This guide is educational and doesn’t replace your MAC’s policies or payer contracts.
