Cardiac Insight Speaks Out Against Medicare Decision to Slash Reimbursement Rates and Limit Access to New ECG Technologies

There has been an increasing trend in cardiology to use longer term remote monitoring wearable ECG tracking devices. This is an example of of the Cardiac Insight Cardea Solo adhesive patch device.

There has been an increasing trend in cardiology to use longer term remote monitoring wearable ECG tracking devices. This is an example of of the Cardiac Insight Cardea Solo adhesive patch device.

February 2, 2021 — Cardiac Insight, Inc. a healthcare company specializing in wearable cardiac sensors and automated electrocardiogram (ECG) analysis, said a recent Medicare reimbursement rate reduction for long-term electrocardiogram (ECG) monitoring is a big set back for patient care.

The rates published by Medicare Administrative Contractor (MAC) Novitas Solutions for CPT codes 93241, 93243, 93245, and 93247 showed up to a 74% reduction in physician reimbursements, Cardiac Insight said.

These include the global and technical components for the newly established Category I codes for long-term ECG monitoring, effective Jan. 1, 2021. Novitas provides administrative and claims processing services for state and federal health care programs such as Medicare and Medicaid and is owned by GuideWell.

“By setting low physician procedure reimbursement on a relatively low-cost, high yield cardiac diagnostic test, CMS and Novitas are ignoring scientific evidence and the professional judgement of thousands of physicians and heart specialists who prescribe ECG wearables because they provide the best and most convenient care for their patients,” said Robert G. Hauser, M.D., FACC, FHRS, former president of the Heart Rhythm Society and Emeritus Senior Consulting Cardiologist, Minneapolis Heart Institute. “The Heart Rhythm Society, American College of Cardiology, American Heart Association, and all patient advocacy groups should object to this ruling by Novitas and the approach taken by the Centers for Medicare and Medicaid Services. Their actions are not in the best interest of patients and certainly do not put patient health first.”

“We are astonished and disappointed by the direction CMS and Novitas have taken, specifically Novitas, with its announcement of a 74% average reduction in physician procedure global reimbursement compared to prior Category III tracking CPT code rates. This untenable decision significantly sets back patient care as it will limit access to extended ECG testing for patients and physicians nationwide,” Harlow said. “We have seen firsthand the positive impact prescription, medical grade ECG wearables make to improve the detection, diagnosis and treatment of life-threatening cardiac arrhythmias in patients at risk, especially for those suffering from atrial fibrillation. These extremely low reimbursement rates will have negative repercussions for health outcomes, especially for the increased risk of stroke and heart failure. Providers and patients, particularly seniors, should be outraged by this decision. We plan to seek additional information from GuideWell and Novitas.”

Cardiac Insight provides an all-inclusive seven-day ambulatory ECG system, the Cardea Solo, that includes in-office rapid automated ECG analysis and reporting to detect arrhythmias, including atrial fibrillation. Cardea Solo speeds the time to diagnosis and simplifies the diagnostic process by enabling clinicians to generate an automated report immediately in-house without the need to outsource to third parties. Long-term continuous ECG monitors like Cardea Solo and those provided by other companies, such as iRhythm Technologies Inc. and Preventice Solutions, have been shown to provide clinical benefits over traditional Holter monitors, as extended ECG recorder wear times can increase diagnostic yield by over 25%.

For more information: www.cardiacinsightinc.com