Stress test CPT code, CPT 93016, cpt code 93016, 93016 cpt code, CPT 93017, cpt code 93017, 93017 cpt code, CPT 93018, cpt code 93018, 93018 cpt code

How To Bill Stress Test CPT Code 93015, CPT 93016, CPT 93017 & CPT 93018

Stress test CPT code 93015 until CPT 93018 describes services where physicians perform cardiovascular stress tests with different techniques. This can be submaximal or maximal bicycle and treadmill exercises, continuous electrocardiographic monitoring, or pharmacological stress. 

1. What Is CPT 93015?

CPT code 93015 can be reported for cardiovascular stress tests with (sub)maximal, bicycle, or treadmill exercise. Both components (professional and technical) are included in this code.

You can find the complete billing guide with the official description of the 93015 CPT code here.

2. What Is CPT 93016?

 CPT code 93016 description
Description of CPT 93016

Stress test CPT code 93016 can be used if a health provider supervises a patient’s heart electrical activity recording to search for abnormalities.

The examination can be done by checking the blood pressure at regular intervals with electrocardiograph readings while the heart is under stress. This is achieved with medication or exercise.

The findings of this test are not interpreted or reported.

2.1 Description

CPT code 93016 is officially described in the CPTs manual as: “Cardiovascular stress test using a maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only, without interpretation and report.”

2.2 Procedure

A health provider supervises a patient undergoing exercises on a bicycle or treadmill to increase the patient’s heart rate. The heart rate can also be increased with medication.

Then, the provider checks the blood pressure and analyzes the electrical activity of the patient’s heart with an electrocardiograph at regular intervals.

After that, the provider does not report the findings or interpret the data.

2.3 Billing Guidelines

Do not report CPT 93016 with a professional or technical component with modifier TC or 26. CPT code 93016 represents the professional component already.

You can report the technical component of this procedure with CPT 93017.

Both components (professional and technical) can be reported with CPT code 93015.

Bill one unit of CPT 93016 per date of service.

2.4 Reimbursement

Below are the costs and RUVs for CPT 93016 when performed in a facility or a non-facility.

CostsRUVs
Facility$23.350.67474
Non-Facility$23.350.67474

3. What Is CPT 93017?

 CPT code 93017 description
Description of CPT 93017

CPT code 93017 may be used for a cardiovascular stress test in which a health provider records the electrical activity of a patient’s heart. The test is done with medication, bicycle, or treadmill exercise to increase the patient’s heart rate.

This code can only be reported for tracing and without report or interpretation.

3.1 Description

The official description of CPT 93017 is defined by the CPTs manual as: “Cardiovascular stress test using a maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; tracing only, without interpretation and report.”

3.2 Procedure

The patient starts with exercises on a bicycle or treadmill to increase the heart rate. The provider can also administer drugs for the same effects. Then, the health provider reads the blood pressure and uses an electrocardiograph at regular intervals.

The data of this cardiovascular stress test is not reported or interpreted.

3.3 Billing Guidelines

CPT 93017 can be used if the test was performed with tracing only. Do not report this code with modifier TC or modifier 26 because it represents a technical component.

One unit of CPT 93017 can be billed per date of service.

3.4 Reimbursement

Below are the costs and RUVS for CPT for 93017 for non-facility and facility.

CostsRUVs
Facility$42.001.21364
Non-Facility$42.001.21364

3. What Is CPT 93018?

 CPT code 93018 description
Description of CPT 93018

Stress test CPT code 93018 may be used for a health provider who interpreted and analyzed the recordings of a patient’s heart electrical activity to search for abnormalities.

The patient’s blood pressure is checked, and the electrocardiograph readings are checked regularly. After that, the provider interprets and reports the findings.

3.1 Description

CPT code 93018 is officially described by CPTs manuals as: “Cardiovascular stress test using a maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; interpretation and report only.”

3.2 Procedure

During the 93018 CPT code stress test procedure, the provider interprets and analyzes the patient’s electrocardiographic data and blood pressure while the patient’s heart is stressed by medication, bicycle, or treadmill exercise to increase the heart rate.

Then, the health provider reports the findings.

3.3 Billing Guidelines

One unit of CPT 93018 can be billed per date of service.

Do not report CPT 93018 with modifier 26 or modifier TC because it already represents a professional component.

You can use CPT 93017 for the technical component and CPT 93015 for both.

3.4 Reimbursement

Below you can find the RUVs and costs for CPT 93018 if performed in a non-facility or a facility.

CostsRUVs
Facility$15.620.45122
Non-Facility$15.620.45122

5. Resources

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleId=57184

https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=56494&ver=7&

https://www.mayoclinic.org/tests-procedures/stress-test/about/pac-20385234

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