Cardiac Insight, Inc., creators of Cardea SOLO™ prescription cardiac sensors and automated electrocardiography (ECG) Analysis Software, shares its perspective on the latest CMS ruling, which provides nationwide physician confidence in receiving the appropriate reimbursement for prescribing LT-ECG (Long Term ECG) ambulatory diagnostic testing. The new Medicare Physician Fee Schedule (MPFS) rule establishes national Medicare and Medicaid payment rates for ambulatory diagnostic ECG solutions, including Cardiac Insight’s Cardea SOLO ECG System.
“This long-awaited milestone provides more healthcare providers and their patients nationwide with greater access to our highly differentiated cardiac arrhythmia detection solutions.”
On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) issued the CY 2023 MPFS Final Rule (CMS-1770-F). In this Final Rule, CMS finalized payment policies and rates for External Extended ECG Monitoring under the MPFS that go into effect on January 1, 2023.
The 2023 MPFS includes payment rates for Category I CPT codes 93241-93248 that cover external ECG testing procedures with an indicated wear-time greater than 48 hours and up to 15 days. Healthcare professionals primarily rely on CPT global code 93241 when billing and seeking reimbursement for Cardiac Insight’s flagship product, the Cardea SOLO ECG System. Cardea SOLO ECG consists of a single-use, chest-worn, 7-day prescription ECG wearable device used with the leading automated arrhythmia Analysis Software operating entirely at the point of clinical patient care. This reduces the need for ECG services outsourcing, relieves the often-associated patient reporting delays and provides economic practice benefits to physicians.
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In the MPFS 2023 Final Rule, CMS established a national relative value unit (“RVU”) of 7.89 for CPT code 93241 and a Calendar Year (“CY”) 2023 Conversion Factor of $33.06, indicating a national payment rate of $260.84
“We appreciate CMS’s evaluation of the cost inputs provided and their focus on establishing national rates for the Long-Term continuous ECG monitoring category,” said Min Kim, Chief Executive Officer of Cardiac Insight. “This long-awaited milestone provides more healthcare providers and their patients nationwide with greater access to our highly differentiated cardiac arrhythmia detection solutions.”
“Our experience is that physician use of Cardea SOLO ECG can streamline cardiac arrhythmia diagnosis, reinforce the physician-patient relationship, and help patients with serious arrhythmias, including atrial fibrillation, obtain treatment sooner,” continued Mr. Kim.