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CPT 93298: 2026 Billing, Modifiers, Reimbursement, and Denial Guide

CPT 93298 loop recorder remote interrogation billing 2026 hero banner: subcutaneous cardiac rhythm monitor over a 30-day period with a 10-day floor, 93297 physiologic monitor versus 93298 rhythm monitor distinction, G2066 deleted January 2024, modifier 26 and TC component split, and the August 2025 Indiana Medicaid modifier 26 claims correction, from One O Seven RCM.

CPT 93298 reports remote interrogation device evaluation of a subcutaneous cardiac rhythm monitor across a monitoring period of up to 30 days. The billed work covers analysis of recorded heart rhythm data, clinical review, and a report.

A physician or qualified healthcare professional performs that professional portion. An implantable loop recorder is the common device. You can bill it globally, or split it with modifier 26 or modifier TC.

Billing teams still get CPT code 93298 wrong for four reasons. Old G2066 remote interrogation workflows sit inside claim templates and vendor articles that still carry 2023 instructions. Competing pages describe 93297 and 93298 backward.

Coders also reach for pacemaker or ICD codes because the device is implanted. And the technical work often runs at a monitoring company while the interpretation happens at the cardiology group, so two organizations bill CPT 93298 for the same 30 days.

The 93298 CPT code description turns on two things: the implantable loop recorder in the patient’s chest, and the data the clinician reviewed. Miss either one and your team sends the claim under the wrong code family.

CMS groups the subcutaneous cardiac rhythm monitor service under 93298 and separates it from external services like Holter monitoring and mobile cardiac telemetry. Novitas Solutions sets that out in its CMS cardiac monitoring guidance.

Below: code selection, component billing, frequency, documentation, 2026 Medicare payment, diagnosis, denials, and a claim workflow. Every rule carries a label, whether it comes from CPT, CMS, a local coverage policy, or a payer.

CPT 93298 Quick Reference for 2026

Code at a Glance

Quick-Reference FieldDetail
CPT code93298
Service categoryRemote interrogation device evaluation
DeviceSubcutaneous cardiac rhythm monitor, including an implantable loop recorder
Data reviewedRecorded heart rhythm data
Service periodUp to 30 days
CPT minimum periodDo not report when the monitoring period runs under 10 days
CPT reporting frequencyReport once per 30 days
Professional component workAnalysis, review, and report by a physician or qualified healthcare professional
Component structureGlobal service, professional component with modifier 26, or technical component with modifier TC
Former technical codeG2066
Status of that codeCMS deleted it effective January 1, 2024
OPPS treatment since 2024Status indicator Q1, meaning STV-packaged, under APC 5741
2026 QP conversion factor$33.57, a Physician Fee Schedule conversion factor and not the code’s payment
2026 non-QP conversion factor$33.40, a Physician Fee Schedule conversion factor and not the code’s payment
Payment variationComponent, locality, facility status, participation category, and payer contract
Main coding riskWrong device or wrong component
Main documentation riskNo evidence supporting the portion billed

CMS finalized two conversion factors for 2026: $33.57 for qualifying alternative payment model participants, and $33.40 for clinicians who don’t qualify. Neither figure is the payment for 93298. Both feed a calculation covered further down this page.

This snapshot gets your team started on CPT 93298 billing guidelines, and the sections below turn each row into a decision. Verification still belongs to you. Your MAC publishes its own coverage rules, your commercial contract sets its own allowed amount, and locality adjusts the Medicare figures. Confirm both against the CMS 2026 PFS final rule before the 93298 CPT code goes out on a claim.

What CPT 93298 Covers and Which Monitor Qualifies

Subcutaneous Cardiac Rhythm Monitor and ILR

A subcutaneous cardiac rhythm monitor sits under the skin of the chest and records heart rhythm information for months at a time. Clinicians call the same device an implantable loop recorder or an insertable cardiac monitor. Once you’ve defined those terms, ILR and ICM work as shorthand.

The loop recorder CPT code for remote review depends on that implanted design. A wearable patch or a Holter recorder sits outside the body and belongs to another code family. A pacemaker paces the heart and an ICD delivers therapy, so both fall outside this subcutaneous cardiac rhythm monitor service.

Work Included in the Remote Service

The billed work starts when the monitoring system receives recorded rhythm data from the implantable loop recorder. From there, the CPT code for implantable loop recorder review covers analysis of that data, clinical review of the findings, and a report signed by the physician or qualified healthcare professional.

One point trips up new billers. Loop recorder interrogation under the CPT code implantable loop recorder rules represents a monitoring period, not a transmission count. A patient can trigger six alerts from a subcutaneous cardiac rhythm monitor in three weeks and still generate one billable service. Frequency gets its own section below.

Services Outside CPT 93298

Service Outside This CodeWhy It Sits Elsewhere
Implanting the monitorSeparate surgical procedure
Removing the monitorSeparate surgical procedure
In-person device evaluationFace-to-face service under a different code
Pacemaker remote monitoringDifferent device family
ICD remote monitoringDifferent device family
Holter monitoringExternal recording service
Mobile cardiac telemetryExternal attended monitoring
Remote physiologic monitoringDifferent monitoring framework

The Heart Rhythm Society places the insertable cardiac monitor inside remote device clinic operations and asks practices to build dedicated staffing, connectivity, and communication workflows around it, per the HRS remote device guidance. Staffing is a billing question too. Whoever runs the technical workflow owns the technical component of CPT 93298.

CPT 93297 vs CPT 93298: Choose by Device and Data

CPT 93297 applies to an implantable cardiovascular physiologic monitor. CPT 93298 applies to a subcutaneous cardiac rhythm monitor. The split depends on the device implanted and the data your clinician reviewed.

The CPT 93298 vs 93297 split runs on device type. Since 2024, both codes carry global, professional, and technical indicators, so component billing is available on either one.

Decision PointCPT 93297CPT 93298
Monitor categoryImplantable cardiovascular physiologic monitorSubcutaneous cardiac rhythm monitor
Main dataPhysiologic cardiovascular dataRecorded heart rhythm data
Monitoring purposeHemodynamic or physiologic trackingRhythm and arrhythmia detection
Remote periodUp to 30 daysUp to 30 days
Component structureGlobal, 26, or TCGlobal, 26, or TC
Common mistakeBilled for a rhythm-only loop recorderBilled for a physiologic monitor

When CPT 93297 Applies

Reach for CPT 93297 when the implanted device tracks physiologic cardiovascular measurements and the report analyzes those measurements. A pulmonary artery pressure sensor sits in a different place again. Remote monitoring of a wireless pulmonary artery pressure sensor maps to 93264, and CPT bars reporting 93297 alongside it.

Plenty of ranking pages still put a CardioMEMS-style sensor on CPT 93297. Check the device record first.

When CPT 93298 Applies

Use CPT 93298 when the implanted device records heart rhythm and the signed report analyzes rhythm episodes. A loop recorder placed after unexplained syncope is the everyday example. The 93297 CPT code doesn’t fit that patient, whatever the vendor portal labels the transmission.

A Three-Step Code Selection Test

Run these three steps in order, every time. First, identify the implanted device from the operative note or the device record. Second, identify the data the clinician analyzed. Third, match the submitted code to what the signed report says.

Worked correctly: a report analyzing recorded rhythm episodes from an implanted loop recorder points to 93298. Worked incorrectly: that same report submitted under 93297 because someone read “implantable monitor” and stopped there.

CMS separates the two codes by monitor and data type, and confirms both received global, professional, and technical indicators under the Physician Fee Schedule for 2024, in its CMS 93297 and 93298 update. That shared structure is exactly why the CPT 93298 vs 93297 decision has to run on device type.

Related Loop Recorder and Remote Monitoring Codes

CPT 93298 does not report insertion, removal, in-person evaluation, pacemaker interrogation, or ICD interrogation. Those services live in separate code families with their own rules.

CPT also blocks several of these combinations outright. Do not report 93298 together with 33285, 93291, 93297, 99091, or 99454. That parenthetical instruction is a CPT rule, so it applies before any payer edit fires.

Monitor Insertion and Removal: 33285 and 33286

CPT 33285 covers insertion of a subcutaneous cardiac rhythm monitor, including programming. The 33285 CPT code description sits with the surgical family, which is why the loop recorder implantation CPT code never doubles as a monitoring charge. CPT 33286 is the loop recorder removal CPT code for the same device.

Two traps here. Implantation doesn’t entitle your practice to bill remote review for that same date, and 33285 gets confused with 93285, the in-person programming device evaluation for the same device. Same-sounding numbers, separate code families.

In-Person Evaluation Codes

In-person device evaluation of a subcutaneous cardiac rhythm monitor uses 93291, not the remote loop recorder CPT code. The report has to show whether the encounter happened remotely or face to face, because that single detail decides the code family. Programming and interrogation are separate concepts, so confirm the current CPT descriptor before assigning either.

Pacemaker and ICD Remote Monitoring Codes

CPT 93294 is the professional component for remote pacemaker monitoring, up to 90 days. CPT 93295 is the professional component for remote ICD monitoring, also up to 90 days. CPT 93296 is the single technical code serving both families.

Those families run on their own clock. CPT limits them to once per 90 days and blocks reporting when the monitoring period runs under 30 days. Copy that logic onto loop recorder interrogation and you generate a frequency denial, because the rhythm-monitor service runs on a 30-day cycle.

ServiceCodeDevice and Core Distinction
Loop recorder insertion33285Subcutaneous cardiac rhythm monitor, places the device
Loop recorder removal33286Subcutaneous cardiac rhythm monitor, removes the device
In-person interrogation93291Subcutaneous cardiac rhythm monitor, face-to-face encounter
Remote rhythm review93298Subcutaneous cardiac rhythm monitor, remote rhythm-data analysis
Remote pacemaker review93294 professional, 93296 technicalPacemaker system, up to 90 days
Remote ICD review93295 professional, 93296 technicalImplantable defibrillator system, up to 90 days

One warning on that last row. The 93296 technical code serves pacemakers and defibrillators only. It is not the technical half of CPT 93298. The broader cardiology CPT code guide separates remote monitoring from ECG, echocardiography, catheterization, and the other cardiovascular families if you need the wider map.

What Changed After G2066, and What Is Current in 2026

G2066 Ended After December 31, 2023

CMS deleted G2066 effective January 1, 2024. Before that date, your technical entity billed G2066 for the data acquisition side of remote interrogation on implanted monitors. Novitas removed the code from its cardiac monitoring article in the same annual update, as the revision history on the CMS cardiac monitoring article confirms.

Anyone asking what replaced G2066 gets a short answer: no standalone code replaced it. CMS folded the technical component work into 93297 and 93298 instead. Old payer PDFs and vendor cheat sheets still show the retired model, so audit your claim templates this quarter.

Why 93297 and 93298 Became Split Billable

CMS added practice expense inputs to both codes for 2024 and assigned them global, professional, and technical indicators. That change is what replaced G2066 in practice. It’s also why a monitoring company can bill the technical component while a cardiology group bills the professional component.

Hospital outpatient departments got a different answer. CMS assigned both codes OPPS status indicator Q1 under APC 5741 effective January 1, 2024. Q1 means STV-packaged, so the payment lands separately only when the code is the sole service on the claim.

What Actually Changed in 2026

Three finalized CY2026 policies move the number on a CPT 93298 claim. CMS split the conversion factor into $33.57 for qualifying APM participants and $33.40 for everyone else. CMS also applied a 2.5% efficiency adjustment that reduces work RVUs on non-time-based services.

Third, CMS cut the facility practice expense RVUs allocated on work RVUs to half the non-facility allocation, which widens the gap between office and hospital settings. New geographic practice cost indices phase in over two years starting this year. CMS posted the July files as CMS July 2026 RVU file RVU26C.

DateChange
January 1, 2024CMS deleted the old technical code and gave 93297 and 93298 global, 26, and TC structure
January 1, 2024OPPS status indicator Q1 and APC 5741 take effect for both codes
January 1, 2026Separate QP and non-QP conversion factors apply
January 1, 2026Efficiency adjustment, facility practice expense change, and new GPCIs take effect
July 1, 2026CMS posts the RVU26C and July national payment files

What Did Not Change in 2026

The device distinction held. So did the up to 30 days service period and the 10-day floor. Anyone asking is G2066 still valid in 2026 should treat the code as retired for Medicare. And no CMS source establishes a 91-day minimum for this code, whatever the SERP says.

How to Bill CPT 93298 Globally or With Modifiers 26 and TC

Submit no modifier when one qualified billing entity performs and documents both portions. Append modifier 26 when your entity performed only the physician or qualified healthcare professional analysis, review, and report.

Append modifier TC when your entity performed only the technical portion. The claim has to match who did the work and who owns it. Payer enrollment and contract terms still need checking before submission.

Billing ArrangementClaim StructureOperational Requirement
One entity performs both portions93298 global, no modifierDocumentation supports both portions
Physician group interprets only93298-26Signed analysis and report on file
Facility or monitoring entity handles data only93298-TCAcquisition, processing, and distribution evidence
Two entities split the serviceOne bills 93298-26, one bills 93298-TCNo duplicate global claim from either side
Ownership is unclearHold the claimConfirm contract, enrollment, and workflow first

Global Billing When One Entity Performs Both Components

CPT 93298 global billing requires one billing entity to stand behind both halves. Seeing both components inside your EHR isn’t the test. The test is whether your organization performed the technical workflow and the interpretation.

Ask one question at the front of every monitoring contract: who receives the transmissions and who processes them? A third party in that chain changes component ownership, and CPT 93298 global billing stops being correct.

Modifier 26 for the Professional Component

Modifier 26 identifies the professional component. The CPT 93298 modifier 26 decision comes down to who analyzed the rhythm data and signed the report. A raw transmission landing in a portal doesn’t support 93298-26 on its own.

Skip CPT 93298 modifier 26 when your entity properly bills the global service. Adding it there understates the claim and conflicts with your own technical charge.

Modifier TC for the Technical Component

Modifier TC identifies the technical component. The CPT 93298 TC modifier belongs to the billing entity that acquires the data, processes transmissions, provides technician review and support, and distributes results. Receiving a finished report doesn’t earn 93298-TC.

Confirm payer enrollment before your technical entity bills 93298-TC. Some plans reject a technical-only claim from an organization enrolled in the wrong category, and that rejection reads like a coding problem.

Split Billing Between Two Entities

Split billing example that works: a monitoring entity runs the technical workflow and submits the CPT 93298 TC modifier claim, while the cardiologist reviews the rhythm data, signs the report, and submits 93298-26. Payer and enrollment rules still apply to both claims.

Split billing example that fails: the physician group and the monitoring entity both submit the global code. The payer sees duplicate component billing, and one or both claims deny or get recouped months later.

Four modifier warnings before you submit. Modifier 59 is not a routine modifier on CPT code 93298. An X modifier is never automatic. Modifier 25 belongs on a separately identifiable evaluation and management code, not on the diagnostic procedure. Check current NCCI edits before any distinct-service modifier goes on the claim.

CMS publishes payment amounts, relative value units, and policy indicators, including modifier applicability and locality adjustment, through the CMS fee schedule lookup. Pull the indicators for 93298 before your team settles on a component strategy.

Practices running several providers, facilities, or monitoring partners need a defined cardiology revenue cycle management workflow so each claim reflects the billing entity that performed the component. Split billing breaks down at the handoff, not at the keyboard.

When component ownership is unclear across your practice and your monitoring partners, a focused workflow review shows where duplicate, missing, or misdirected billing starts.

How Often Can CPT 93298 Be Billed?

CPT instructs you to report 93298 once per 30 days, and it blocks the code when the monitoring period runs under 10 days. One unit covers one documented monitoring period of up to 30 days.

Payers layer their own edits on top of that CPT rule. Check the payer’s current frequency edit, the dates inside the report, and any previously billed period before the claim goes out.

One Unit Represents a Monitoring Period

One unit of CPT 93298 represents the documented remote interrogation service. The unit doesn’t attach to a transmission, an alert, or a symptomatic event. Several transmissions can fall inside one monitoring period, and one alert doesn’t create a second billable unit.

Your report should name the period the claim represents. A device clinic that logs start and end dates on every interpretation settles most frequency disputes without a phone call.

What Up to 30 Days Means

Four separate rules hide behind the CPT 93298 30-day rule, and billers collapse them into one. The CPT service period covers up to 30 days. The CPT reporting rule allows one report per 30 days. A payer frequency limit is a separate edit. And a payer’s date of service instruction is separate again.

Novitas states the once per 30 days instruction for external mobile telemetry codes 93228 and 93229 in its CMS cardiac monitoring guidance, and doesn’t repeat that sentence for 93298. The CPT parenthetical still governs, so treat the 30-day cycle as a coding rule and the submission date as a payer question.

Check for Overlapping Billing Periods

Run this check before submission. Pull the start and end dates from the current report, open the previous CPT code 93298 claim, and compare the two service periods.

Flag any overlapping dates, confirm which entity billed which component, and review the payer’s frequency edit. When you can’t verify the period, hold the claim rather than testing it against the payer’s system.

Verify the Payer’s Frequency Rule

Rule TypeWhat Your Team Verifies
CPT service definitionPeriod covers up to 30 days, minimum 10 days, one report per 30 days
Medicare national ruleCurrent Physician Fee Schedule indicators and applicable MAC guidance
Medicaid ruleState program manual and managed care organization instructions
Commercial ruleMedical policy language and the payer contract
Internal billing controlPrior service period and the component already billed

Medicare, Medicaid, Medicare Advantage, and commercial claims don’t process under identical edits. Anyone asking how often can CPT 93298 be billed needs both answers: the CPT rule sets the cycle, and the payer sets the submission mechanics.

CPT 93298 Documentation Requirements

The medical record must identify the patient and the service dates, and it must support both the procedure and the diagnosis you submitted. The professional portion needs analysis, review, and a signed report.

The technical portion needs evidence that your entity performed the technical work. Your team should be able to name the monitoring period and the responsible billing entity from the record alone.

CMS requires records to stay available to the contractor, to carry patient identification and a legible practitioner signature, to support the selected diagnosis and procedure, and to include the monitoring interpretation with the interpreting physician’s name, per Novitas in its CMS documentation requirements. Coverage criteria sit in the related LCD L39490.

Documentation for the Professional Component

ElementWhat the Record Shows
Patient identificationName and identifying information on every page
DeviceType of subcutaneous cardiac rhythm monitor in place
Monitoring periodStart and end dates the interpretation covers
Rhythm findingsRelevant episodes captured during the period
Clinical interpretationPhysician or qualified healthcare professional analysis of those findings
Action takenAssessment or plan when the findings warrant one
Signature and dateLegible signature of the interpreting clinician and the review date

A raw device transmission is not a physician interpretation. The signed report should show the clinician analyzed and reviewed the data. An abnormal result is never a condition of billing, though the record still has to support why the service was medically necessary.

Documentation for the Technical Component

Read the next table as recommended technical audit evidence, not as a list of universally mandated CMS fields. These are the artifacts that hold up when a payer asks your technical entity to prove the work.

Recommended Technical Audit EvidencePurpose
Data receipt confirmationShows transmissions arrived during the billed period
Device and patient matchingTies the transmission to the correct chart
Transmission processing recordDocuments the technical work performed
Technician review and support logEvidences the review and support activity
Results distribution recordShows results reached the ordering clinician
Monitoring period trackingSupports the dates on the claim
Technical entity identityNames the organization billing 93298-TC

Monitoring Period and Transmission Records

Start and end dates in the CPT 93298 transmission log should match the billed period. The log ties to one patient and one device. Several alerts can occur inside a single service period without changing the unit count.

Never represent missing transmissions as completed technical work. Your billing record should also name which organization performed each component, because that single field settles most component disputes at appeal.

Final Audit-Ready Checklist

Seven items close out CPT 93298 documentation requirements: correct patient and device, documented monitoring period, supporting transmission record, completed professional interpretation, responsible practitioner signature, medical necessity in the record, and the correct billing entity and component.

Run that checklist before submission and you catch the 93298 CPT code description mismatches that surface later as denials. The standard: someone outside your office should reach the same conclusion from the same chart.

CPT 93298 Reimbursement in 2026

CPT 93298 reimbursement 2026 figures shift with the component billed, the geographic locality, facility status, the clinician’s participation category, and the payer contract. Medicare doesn’t publish one universal amount for every claim.

The safe approach hasn’t changed: verify the global, professional, or technical payment inside the current CMS files, then compare the allowed amount against the remittance you receive.

How Medicare Calculates Payment

Medicare builds the payment in two steps. Geographic practice cost indices adjust each relative value unit, then the applicable conversion factor turns the total into dollars.

StepCalculation
Step 1Adjusted work RVU + adjusted practice expense RVU + adjusted malpractice RVU = total adjusted RVUs
Step 2Total adjusted RVUs x applicable conversion factor = estimated Medicare payment

Two 2026 policies push against each other inside that math. CMS finalized conversion factors of $33.57 for qualifying APM participants and $33.40 for everyone else, and separately applied a 2.5% efficiency adjustment that lowers work RVUs on non-time-based services. Conversion factors are not the code’s payment.

Global, Professional, and Technical Payment

Verify seven values before quoting a number internally: global, modifier 26, modifier TC, facility, nonfacility, QP, and non-QP. Don’t assume the global rate equals a sum copied off a third-party site.

How to Verify the Current Amount

Open the July 2026 CMS relative value file, find the 93298 CPT code, and review the PC and TC indicators. Then open the July 2026 national payment file, select QP or non-QP, and confirm the facility and nonfacility amounts.

Check your practice locality last, then compare the allowed amount on the electronic remittance advice. CMS identifies RVU26C as the July 2026 Physician Fee Schedule release in the CMS July 2026 RVU file, and publishes a matching national payment file with separate QP and non-QP amounts.

One number to avoid repeating: no verified CMS source supports a single flat CPT 93298 Medicare reimbursement figure applied to every claim. Pages quoting one specific dollar amount for all localities and components are guessing.

Commercial Payer Reimbursement

Your contract controls the commercial allowed rate. A payer can price the global service, the 26 component, and the TC component on three different lines of its fee schedule, so compare each against the contracted amount rather than the Medicare figure.

A paid claim can still be underpaid. When the remittance lands below contract, structured AR follow-up services should compare the remittance, the component billed, and the fee schedule before anyone writes the balance off.

ICD-10 and Medical Necessity for CPT 93298

The diagnosis on the claim must match the documented reason for remote cardiac rhythm monitoring. A diagnosis code doesn’t support payment by itself.

Your medical record should explain the symptoms, the known rhythm condition, the abnormal finding, or the clinical suspicion that led to continued monitoring. That explanation is the medical necessity, and the ICD-10 code only points at it.

The Diagnosis Must Match the Clinical Reason

Clinical indications that commonly support this service include syncope, dizziness, palpitations, suspected arrhythmia, atrial fibrillation, conduction disturbance, and abnormal cardiac testing. Treat those as categories, not as a coverage promise.

Novitas Solutions lists 153 ICD-10 codes that support medical necessity for a code group including 93298, per its CMS medical necessity guidance. That list is local coverage policy tied to LCD L39490, covering Jurisdictions JH and JL: Colorado, New Mexico, Oklahoma, Texas, Arkansas, Louisiana, Mississippi, Delaware, the District of Columbia, Maryland, New Jersey, and Pennsylvania.

Practices outside those twelve jurisdictions need their own MAC policy. Treating a Novitas list as a national list builds a denial pattern fast.

Avoid Diagnosis Code Shortcuts

Five shortcuts cause most medical necessity denials on this service. Picking an unspecified diagnosis because it looks payable. Using a device presence code without documenting why monitoring continued.

Copying the diagnosis from an old claim. Reusing the implant diagnosis for every later monitoring period. And borrowing the diagnosis list from the physiologic monitor code without checking which device sits in the patient’s chart.

Verify MAC and Payer Coverage

Four steps close this out. Confirm the clinical indication in the chart, select the most specific supported diagnosis, review the applicable MAC or payer policy, and confirm the note supports the code before the claim leaves your queue.

CPT 93298 Denial Reasons and How to Fix Them

CPT 93298 denial reasons cluster in five places: the device, the service period, the component billed, the supporting report, and the payer’s current edit. Work them in that order.

Don’t resubmit the same claim unchanged. Decide first whether the claim needs a corrected submission, a formal appeal, a component adjustment, or a payer escalation, because those four paths have different deadlines.

Denial CategoryVerifyCorrective ActionPrevention
Wrong deviceDevice record against the reportCorrect the code when documentation supports itDevice-to-code mapping at intake
Wrong componentGlobal, 26, or TC ownershipCorrect the component and resubmitBilling entity profile per contract
Duplicate periodCurrent and prior service datesCorrect the overlap or appeal with datesPeriod tracking log
Missing reportSigned interpretation on fileObtain or locate valid documentationProvider work queue with due dates
Medical necessityDiagnosis against the clinical noteCorrect or appeal with the supporting recordPrebill diagnosis review
NCCI editCurrent code pair and modifier indicatorApply a modifier only when the edit supports itQuarterly edit check
MUE issueUnits billed against the date of serviceCorrect units or appeal with recordsUnit validation rule
Payer system errorPolicy language against the remittanceRequest reprocessing or appealPayer bulletin monitoring

Wrong Device or Code Family

Confirm the patient has a subcutaneous cardiac rhythm monitor rather than a pacemaker, an ICD, an external monitor, or a physiologic monitor. Compare the submitted code against the report, and change the code only when the documentation supports the change. Never recode a claim to make it payable.

Global and Component Billing Conflicts

Check whether another entity billed the opposite component, and look for two global claims covering the same period. Review the monitoring company agreement, confirm whether the physician group submitted 26 or global, and read the remittance before anyone resubmits.

Frequency and Period Overlap

Compare start and end dates against the prior remittance, then review the payer’s frequency logic. Decide whether the denial is valid under the CPT 30-day cycle or whether the payer applied an edit that doesn’t fit this code.

NCCI, MUE, and Payer System Errors

CMS uses NCCI procedure-to-procedure edits to prevent payment on code combinations that shouldn’t be reported together unless a clinically appropriate modifier applies. The current quarter edits took effect July 1, 2026, per the CMS NCCI PTP edits. Our CO-4 modifier denial guide walks the modifier-conflict path in detail.

CMS defines a medically unlikely edit as the maximum units reported on most for the same code, provider, beneficiary, and date of service, in the CMS Medicare MUE files. Not every code carries a published MUE, and CMS keeps some values confidential, so a units denial isn’t always traceable to a public table.

Payer configuration causes denials too. Indiana Medicaid published BT2025127 on August 28, 2025, confirming that claims for 93298 billed with modifier 26 had been denying incorrectly. The IHCP corrected its claim-processing system and reprocessed claims for dates of service on or after August 28, 2023, with adjusted remittances beginning October 15, 2025, per Indiana Medicaid bulletin BT2025127.

Keep that example in front of your AR team. A denial on the CPT code 93298 claim can come from payer configuration rather than your coder’s work, and reading the bulletin history is the only way to tell.

When the same denial keeps returning, the claim is exposing a workflow problem. A focused claim denial management services review shows whether the break sits in device mapping, component ownership, documentation, or payer follow-up.

A Clean Claim Workflow for CPT 93298

Seven Checks Before Claim Submission

Run these seven CPT 93298 checks in order, on every claim: confirm the implanted device, match the device and data to the correct code, verify the monitoring period against the report, identify global, professional, or technical ownership, confirm the interpretation and technical evidence exist, validate diagnosis, payer policy, NCCI edits, and units, then compare the claim against the payment you expect.

A claim shouldn’t leave your billing queue until the device, the period, the component, the documentation, and the payer rule all tell the same story. When one of those five disagrees with the others, the payer finds it before you do.

When Full-Service RCM Becomes Practical

Outsourcing earns its keep once a practice runs several billing entities, multiple device platforms, recurring component denials, unworked underpayments, inconsistent provider signatures, or new physicians waiting on payer enrollment.

One O Seven RCM connects coding, claim submission, denial management, payment posting, AR follow-up, billing audits, and provider credentialing under one team, so nobody points at another vendor when a device-clinic claim stalls.

One O Seven RCM Pricing for Cardiology Practices

One O Seven RCM ServicePricing
Full-service medical billing and RCM3% of total collections
Upfront feeNone
Setup chargesNone
Provider credentialing$107 per payer

One O Seven RCM is one of the most affordable and experienced full-service billing companies working with cardiologists and device clinics. Our RCM services run at 3% of total collections, with no upfront fee and no setup charges. Provider credentialing is $107 per payer.

That pricing puts specialty-trained cardiology billing inside reach of independent device clinics. A medical billing audit is the usual starting point, and provider credentialing services handle enrollment when a new clinician joins the monitoring roster.

When your team tracks device periods, component ownership, payer edits, and unpaid claims in separate spreadsheets, the gaps stay invisible until the remittance arrives. We will review the complete workflow and show you where claims stop.

Request a free billing audit: Request a Free Billing Audit

Frequently Asked Questions About CPT 93298

What Is the 93298 CPT Code Description?

The 93298 CPT code description covers remote interrogation device evaluation of a subcutaneous cardiac rhythm monitor for a period of up to 30 days. It includes analysis of recorded rhythm data, clinical review, and a report by a physician or qualified healthcare professional. You can bill it globally or split it into professional and technical components.

What Is the CPT Code for Implantable Loop Recorder Remote Monitoring?

CPT 93298 is the CPT code for implantable loop recorder remote rhythm review. CPT 33285 reports insertion of the monitor, and 33286 reports removal. The 93298 CPT code never covers the procedure itself, so match the code to the service your clinician performed and documented on that date.

Can CPT 93297 and CPT 93298 Be Billed Together?

No. CPT instructs you not to report 93298 together with 93297, because the two codes describe different monitor and data categories. Don’t submit both to capture professional and technical components, since each code carries its own 26 and TC structure. Verify which device the patient has, then bill the CPT code 93297 or the rhythm-monitor code alone.

Is G2066 Still Valid in 2026?

No. CMS deleted G2066 effective January 1, 2024, and Medicare billing now uses the component structure assigned to 93297 and 93298. Old vendor articles and claim templates still show the retired workflow. Check your non-Medicare payer instructions before you change an existing claim, because some plans update their manuals on a different schedule.

Does a Device Alert Create Another Billable Service?

No. A device alert doesn’t create another unit of CPT 93298. The code represents one documented remote interrogation period, and CPT limits reporting to once per 30 days with a 10-day minimum. Check the current period, the prior claim, the report, and the payer’s frequency rule before adding a second unit.

Getting CPT 93298 Right, Claim After Claim

Correct billing on this code comes down to five things agreeing with each other: the device, the monitoring period, the component, the documentation, and the payer rule. Retired G2066 guidance shouldn’t drive a single current Medicare claim.

Match the claim to the work your team performed, and most of these denials stop happening. If yours keep returning, request a free billing audit and we’ll show you where the workflow breaks.

Policy Sources Reviewed

Policy sources reviewed: July 31, 2026. Update this date only when the source review is repeated.

Editorial Disclosure

This article is intended for provider billing education. CPT, Medicare, Medicaid, MAC, and commercial payer policies may change. Verify the current code set, applicable coverage policy, fee schedule, and payer contract before submitting a claim. CPT is a registered trademark of the American Medical Association.

Sources

Source GroupReference
CMS coding and paymentNovitas Solutions, Billing and Coding: Ambulatory Electrocardiograph (AECG) Monitoring, A59268; LCD L39490; CMS Physician Fee Schedule; CMS PFS Relative Value Files, RVU26C (July 2026 release)
CMS OPPSMLN Matters MM13568, April 2024 Update of the Hospital Outpatient Prospective Payment System (CR 13568, Transmittal 12552)
CMS NCCI and MUEMedicare NCCI Procedure-to-Procedure Edits, effective July 1, 2026; Medicare NCCI Medically Unlikely Edits, effective July 1, 2026
Cardiology professional guidance2023 HRS/EHRA/APHRS/LAHRS Expert Consensus Statement on Practical Management of the Remote Device Clinic
State payer updateIndiana Health Coverage Programs bulletin BT2025127, August 28, 2025
Code setAMA CPT 2026 code set and the parenthetical instructions accompanying 93297 and 93298

About the Author

Carter Hensley

Carter Hensley is a professional medical billing content writer with a strong focus on coding accuracy, compliance, and revenue optimization. He develops detailed content around CPT procedures, ICD-10 classifications, AR follow-up, credentialing processes, and denial resolution strategies. His writing is designed to support healthcare providers with practical knowledge that improves clean claim rates and ensures adherence to payer guidelines. At One O Seven RCM, Carter produces expert-level content that bridges the gap between clinical documentation and efficient revenue cycle performance.

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