CPT 93296 covers the technical side of remote pacemaker and defibrillator monitoring: receiving the transmissions, technician review, technical support and distributing results. Who may bill it depends entirely on who actually provides that infrastructure.
What CPT 93296 covers
93296 is remote interrogation device evaluation of a single, dual or multiple lead pacemaker system or implantable defibrillator system, up to 90 days, covering remote data acquisition, receipt of transmissions, technician review, technical support and distribution of results.
One technical code serves both device types, which is why it pairs with either 93294 or 93295 on the professional side.
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.
Not the same as remote physiologic monitoring
These codes are frequently confused with the remote physiologic monitoring family (99453, 99454, 99457 and 99458), which covers monitoring of physiologic parameters such as weight, blood pressure and pulse oximetry using a supplied device.
They are different services with different rules, different time periods and different documentation. A cardiac implantable device being monitored remotely belongs in the 93294 to 93299 family. Billing it under the RPM codes, or the reverse, produces denials that look mysterious until the families are separated.
Reimbursement context
Remote monitoring is a recurring revenue stream rather than a one-off procedure, so the economics depend on billing every eligible period exactly once.
Medicare pays for this code under the Physician Fee Schedule, and the amount depends on where you practise. Each code carries relative value units for physician work, practice expense and malpractice, each adjusted by a geographic practice cost index (GPCI) for the locality, and the total is multiplied by the conversion factor:
(work RVU × work GPCI + practice expense RVU × PE GPCI + malpractice RVU × MP GPCI) × conversion factor
For 2026 the conversion factor is $33.4009 for practitioners who are not qualifying APM participants and $33.5675 for qualifying APM participants, as set in the CY 2026 Physician Fee Schedule final rule (CMS-1832-F; see the CMS fact sheet). Because the RVUs differ by code and the GPCIs differ by locality, what your practice is paid will differ from any national average. Pull the RVUs and the payment for your own locality from the CMS Physician Fee Schedule Look-Up Tool.
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 by an entity that does not provide the technical service
Where a third-party monitoring service receives and processes transmissions, that entity bills the technical component. A practice billing it as well produces a duplicate for the period.
Fix: map each monitoring arrangement to the entity actually providing data acquisition and technician review, and bill the technical component from there only.
Modifier TC appended
93296 is already the technical code.
Fix: submit with no component modifier.
Billed on the wrong cycle
This code runs on the 90-day period alongside 93294 and 93295.
Fix: bill once per 90 days. For implantable monitors on the 30-day cycle, the technical component under Medicare is modifier TC on 93297 or 93298.
Modifier rules
- 93294, 93295, 93296: no 26 or TC. The professional and technical work is split through separate codes, so appending a component modifier is redundant and can cause a rejection.
- 93297, 93298: for Medicare, modifier 26 (professional) and TC (technical) apply when two entities provide the two parts. Billed globally, with no modifier, when one entity provides both.
- 59 / XE / XP / XS / XU: rarely applicable, and never a route to reporting the same monitoring period twice.
- 25: on an E/M where a separately identifiable visit occurred, never on the monitoring code.
- GY / GA: where a service is statutorily excluded or an advance beneficiary notice is on file, per payer instruction.
NCCI bundling edits
- 93296 with 93294 or 93295: separately reportable as the technical and professional components.
- 93296 reported twice in one 90-day period: duplicate.
- 93296 with 93297 or 93298: different device families and different periods. Report the code matching the device.
- Modifier TC is not used, because the code is already technical-only.
Frequently asked questions
Who bills CPT 93296?
Does 93296 cover both pacemakers and defibrillators?
Should modifier TC be appended to 93296?
Sources
American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual and quarterly edit tables, cms.gov.
Centers for Medicare & Medicaid Services, Physician Fee Schedule Look-Up Tool, cms.gov.
American College of Cardiology, acc.org. AAPC coding resources, aapc.com.
CPT® is a registered trademark of the American Medical Association. Code descriptors are summarised here for billing guidance and are not a substitute for the current CPT codebook. Payer rules and NCCI edits change quarterly; verify against your own payer policy before submission.
Related codes
- CPT 93294. Remote pacemaker check, physician component.
- CPT 93295. Remote ICD check, physician component.
- CPT 93297. Remote implantable physiologic 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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