Microlife Medical Home Solutions Inc. WatchBP programs are cost-effective for physician practices.  Standard CPT and E/M codes are applicable with WatchBP O3 ABPM and PracticeWare programs.

 

 

ABPM Reimbursement

Many payers including Medicare, Medicaid, and private insurance companies reimburse ABPM evaluation for hypertensive and at-risk patients.  The amount reimbursed varies by region, payer, and policy.  Currently, the allowable coverage by Medicare is between $60-$120.  For the latest allowable rate by Medicare visit the CMS physician fee schedule website.  The allowable rate by private insurance carriers is between $75-$300.  Click here to download the Ambulatory Blood Pressure Reimbursement guide.

 

CPT Codes

 

  93784      ABPM utilizing a system (i.e., WatchBP 03) for 24 hours or longer, including

                recording, scanning analysis, interpretation and report.

 

  93786      Recording only. 

 

  93788      Scanning analysis with report.

 

  93790      Physician review with interpretation and report.

 

 

ICD-9 Codes

Currently, only Medicare reimburses ABPM for patients with suspected "white coat" hypertension. This requires the patient to meet specific qualifying criteria. For more information, please view Medicare's policy and instructions for ABPM reimbursement.

 

 

 

401	Essential hypertension	458	Orthostatic hypotension
401.1	Benign hypertension	458.9	Unspecified hypotension
401.9	Unspecified hypertension - (Resistant)	642	Hypertension complicating pregnancy, childbirth and puerperium
402	Hypertensive heart disease	642.3	Transient hypertension of pregnancy
402.1	Benign hypertensive heart disease	642.4	Mild or unspecified preeclampsia
402.10	Benign hypertension without congestive	642.9	Unspecified hypertension complicating pregnancy
402.9	Unspecified hypertensive heart disease	669.2	Maternal hypotension syndrome
402.90	Unspecified hypertension without congestive heart failure	780.2	Syncope and collapse
403	Hypertensive renal disease	796.2	Elevated blood pressure reading without diagnosis of hypertension. Medicare Only.
413	Nocturnal angina	997.91	Other hypertension – episodic
429	Ill-defined descriptions and complications of heart disease

 

 

HBPM Reimbursement

Under a recent Call to Action from the American Heart Association, insurance companies are increasingly open to reimbursement of HBPM at the primary care level.¹ Even if private payer carriers do not cover HBPM, patient's can purchase the WatchBP Home through various flexible spending accounts (FSA).  Patients can choose to purchase the WatchBP Home device from their physician or from Microlife Medical Home Solutions, Inc.

 

If you are interested in distributing the WatchBP Home devices to your patients please contact our business development team at info(at)MiMHS.com.

 

For additional reimbursement  information please contact Microlife Medical Home Solutions at info(at)MiMHS.com

 

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1  Call to Action on Use and Reimbursement for Home Blood Pressure Monitoring; Thomas G. Pickering et al; Hypertension 2008;52;1-9; originally published online May 22, 2008.