CPT 93294 covers the physician analysis, review and report for remote monitoring of a pacemaker system across a period of up to 90 days. It is a recurring code, and nearly every denial on it comes down to the calendar rather than the clinical work.
What CPT 93294 covers
93294 is remote interrogation device evaluation of a single, dual or multiple lead pacemaker system, up to 90 days, with interim physician analysis, review(s) and report(s).
It is the professional component. The technical side, meaning the data acquisition, technician review and distribution of results, is reported separately with 93296 by whoever provides that infrastructure.
How the remote device monitoring family is organised
Pacemakers and defibrillators use a professional code and a technical code. Implantable monitors changed for Medicare in 2024, so read the last three lines carefully.
- 93294: pacemaker system, remote, physician analysis, review and report. Up to 90 days.
- 93295: implantable defibrillator system, remote, physician analysis, review and report. Up to 90 days.
- 93296: pacemaker or defibrillator system, remote, technical. Data acquisition, receipt of transmissions, technician review, technical support and distribution of results. Up to 90 days.
- 93297: implantable cardiovascular physiologic monitor, remote evaluation. Up to 30 days.
- 93298: subcutaneous cardiac rhythm monitor, including implantable loop recorders, remote evaluation. Up to 30 days.
- 93299: CPT's technical-only code for those two monitor types. Medicare does not use it. CMS created G2066 for the technical component in 2020, deleted G2066 for 2024, and accepted the practice-expense inputs on 93297 and 93298 instead. For Medicare the technical component is reported with modifier TC on 93297 or 93298.
Reimbursement context
2026 Medicare RVUs for CPT 93294
| CPT 93294: 2026 Medicare RVUs (national, before GPCI) | ||||||
|---|---|---|---|---|---|---|
| Line | Work | PE, non-facility | PE, facility | Malpractice | Total, non-facility | Total, facility |
| Global (no modifier) | 0.59 | 0.25 | 0.25 | 0.04 | 0.88 | 0.88 |
Source: CMS CY 2026 PFS Relative Value File, RVU26D (October release, published 08/26/2026). RVUs are national and unadjusted; commercial payers set their own rates.
In the 2026 CMS relative value file, CPT 93294 carries 0.59 work RVUs and 0.88 total RVUs, the same in facility and non-facility settings. Its PC/TC indicator is 2: 93294 is itself a professional-component-only code, so modifier 26 is never added to it. Its global indicator is XXX: the surgical global period concept does not apply. Across the remote device monitoring codes, work RVUs run from 0.51 (93297) to 0.72 (93295); 93294 sits at 0.59.
To turn RVUs into payment, each component is multiplied by your locality's geographic practice cost index, the three are added, and the sum is multiplied by the 2026 conversion factor: $33.4009, or $33.5675 for qualifying APM participants (CMS-1832-F; CMS fact sheet). The CMS Physician Fee Schedule Look-Up Tool runs that calculation for your locality.
Documentation requirements
- The device type and model, and the date of implant.
- At least one transmission received and reviewed within the 90-day period.
- The dates the monitoring period began and ended.
- The data elements reviewed, not merely that a transmission arrived.
- A dated, signed report of the analysis and any clinical action taken, where the professional component is billed.
- Evidence of the technical infrastructure and technician review, where the technical component is billed.
- Confirmation that the period has not already been billed for this patient and device.
Common denials and the exact fix
Reported more than once in the same period
The most common denial in this family. The code covers the whole monitoring period, so a second claim inside it is a duplicate no matter how many transmissions arrived.
Fix: track the period start date per patient and per device, and let the billing system rather than the calendar month drive the claim.
No transmission received in the period
A period with no transmission does not support the code, even where the equipment was in place and the patient was enrolled.
Fix: confirm at least one transmission was received and reviewed before billing, and work the non-transmitting patient list as an operational task rather than a billing one.
Billed on a 30-day cycle
Pacemaker and defibrillator remote monitoring runs on a 90-day period. Monthly billing produces duplicate denials for two out of every three claims.
Fix: move pacemaker monitoring to a 90-day billing cycle. The 30-day cycle belongs to the implantable monitor codes.
Modifier 26 appended
93294 is already the professional code. For pacemaker and defibrillator monitoring the split runs through separate codes, not component modifiers.
Fix: submit with no component modifier.
Report not produced or not signed
The code pays for analysis, review and a report. A transmission reviewed without a dated, signed report does not support it.
Fix: generate and sign an interim report for each billed period.
Modifier rules
- 26 / TC: not used. 93294 is itself the professional code for pacemaker monitoring; the technical work is billed as 93296.
- 59 / XE / XP / XS / XU: rarely applicable to 93294, and never a route to reporting the same 90-day period twice.
- 25: on a same-day E/M that was separately identifiable, never on the 93294 line.
- GY / GA: where a service is statutorily excluded or an advance beneficiary notice is on file, per payer instruction.
NCCI bundling edits
- 93294 with 93296: separately reportable, since they are the professional and technical components reported by different entities.
- 93294 reported twice in one 90-day period: duplicate.
- 93294 with 93295: report the code matching the device. A defibrillator system is reported with 93295.
- 93294 with the remote physiologic monitoring codes: different family, different service.
- In-person device interrogation: reported with its own code family; check current CPT guidance and payer policy on overlap with a remote period.
Frequently asked questions
How often can CPT 93294 be billed?
Do I need a transmission to bill 93294?
Should modifier 26 be appended to 93294?
Sources
American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, CY 2026 PFS Relative Value File RVU26D (October release): RVUs, PC/TC indicator and global period for CPT 93294.
Centers for Medicare & Medicaid Services, CY 2026 Physician Fee Schedule final rule, CMS-1832-F: conversion factors.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual for Medicare Services and quarterly procedure-to-procedure edit tables.
Heart Rhythm Society summary of the CY 2024 PFS final rule (deletion of G2066 and the practice-expense inputs moved to 93297 and 93298).
CPT® is a registered trademark of the American Medical Association. Payer policy and NCCI edits change quarterly, so check your own contractor before submission. How we verify this guidance.
Related codes
- CPT 93295. Remote ICD check, physician component.
- CPT 93296. Remote pacemaker or ICD check, technical component.
- CPT 93297. Remote implantable physiologic monitor, 30 days.
More cardiology code guides
- CPT 93325. Color flow Doppler add-on.
- CPT 93350. Stress echo, imaging only.
- CPT 93351. Stress echo including ECG monitoring and supervision.
Related reading
- Cardiology billing & RCM. How we scrub cardiology claims across diagnostics, cath lab, EP and remote monitoring.
- Cardiac RPM billing compliance. Transmission windows, documentation and the rules that trip up remote monitoring claims.
- TC/26 modifier errors in cardiology. The split-billing mistakes that cost diagnostic practices the most.
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