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.
Where 93296 sits in the device monitoring family
93296 is the technical half for both pacemaker and defibrillator systems: data acquisition, receipt of transmissions, technician review, technical support and distribution of results, up to 90 days. It pairs with 93294 (pacemaker) or 93295 (defibrillator) for the professional work. It does not apply to implantable monitors, whose 30-day codes 93297 and 93298 carry their own technical component for Medicare. See the full device monitoring family map on the CPT 93294 guide.
Reimbursement context
2026 Medicare RVUs for CPT 93296
| CPT 93296: 2026 Medicare RVUs (national, before GPCI) | ||||||
|---|---|---|---|---|---|---|
| Line | Work | PE, non-facility | PE, facility | Malpractice | Total, non-facility | Total, facility |
| Global (no modifier) | 0.00 | 0.94 | NA | 0.01 | 0.95 | NA |
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 93296 carries 0.00 work RVUs and 0.95 total RVUs. The facility column is NA: CMS values this code only for a non-facility setting such as an office. Its PC/TC indicator is 3: 93296 is itself a technical-component-only code, so modifier TC is never added to it. Its global indicator is XXX: the surgical global period concept does not apply.
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 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
- 26 / TC: not used. 93296 is itself the technical code; the professional work is billed as 93294 or 93295.
- 59 / XE / XP / XS / XU: rarely applicable to 93296, 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 93296 line.
- 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, CY 2026 PFS Relative Value File RVU26D (October release): RVUs, PC/TC indicator and global period for CPT 93296.
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 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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