CPT 93295 covers the physician analysis, review and report for remote monitoring of an implantable defibrillator system across a period of up to 90 days. It is the defibrillator counterpart to 93294, and mixing the two up is a routine source of denials.
What CPT 93295 covers
93295 is remote interrogation device evaluation of a single, dual or multiple lead implantable defibrillator system, up to 90 days, with interim physician analysis, review(s) and report(s).
It is the professional component for a defibrillator. The technical work is reported with 93296, which covers both pacemaker and defibrillator systems.
Where 93295 sits in the device monitoring family
93295 is the professional half of remote defibrillator monitoring: the physician's analysis, review and report for an implantable defibrillator system, up to 90 days. The technical half, data acquisition and transmission handling, is 93296, shared with pacemakers. Pacemaker systems use 93294 instead. Implantable monitors (93297, 93298) run on 30-day periods under different rules, and they are not remote physiologic monitoring (99453 to 99458) either. See the full device monitoring family map on the CPT 93294 guide.
Reimbursement context
2026 Medicare RVUs for CPT 93295
| CPT 93295: 2026 Medicare RVUs (national, before GPCI) | ||||||
|---|---|---|---|---|---|---|
| Line | Work | PE, non-facility | PE, facility | Malpractice | Total, non-facility | Total, facility |
| Global (no modifier) | 0.72 | 0.31 | 0.31 | 0.05 | 1.08 | 1.08 |
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 93295 carries 0.72 work RVUs and 1.08 total RVUs, the same in facility and non-facility settings. Its PC/TC indicator is 2: 93295 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), so 93295 carries the highest physician work in its group.
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.
Wrong device code selected
93294 is for pacemaker systems and 93295 for defibrillator systems. A defibrillator billed under the pacemaker code under-reports the service, and the reverse over-reports it.
Fix: drive code selection from the device record rather than from a default in the billing template.
Billed on a 30-day cycle
Defibrillator remote monitoring runs on a 90-day period.
Fix: bill once per 90 days. The 30-day cycle belongs to the implantable monitor codes.
Therapy events reviewed but not documented
Defibrillator monitoring frequently surfaces arrhythmia episodes and delivered therapies. Reviewing them without recording the findings weakens the claim.
Fix: record the episodes reviewed, the therapies delivered and any programming change in the signed report.
Modifier rules
- 26 / TC: not used. 93295 is itself the professional code for defibrillator monitoring; the technical work is billed as 93296.
- 59 / XE / XP / XS / XU: rarely applicable to 93295, 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 93295 line.
- GY / GA: where a service is statutorily excluded or an advance beneficiary notice is on file, per payer instruction.
NCCI bundling edits
- 93295 with 93296: separately reportable as professional and technical components.
- 93295 with 93294: report the code matching the device, not both.
- 93295 reported twice in one 90-day period: duplicate.
- 93295 with the remote physiologic monitoring codes: different family.
Frequently asked questions
What is the difference between CPT 93294 and 93295?
How often can 93295 be billed?
What should the report contain for a defibrillator?
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 93295.
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 93294. Remote pacemaker check, physician component.
- CPT 93296. Remote pacemaker or ICD check, technical component.
- CPT 93298. Remote subcutaneous rhythm monitor, 30 days.
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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