Mobile Cardiac Telemetry (MCT) Reimbursement
Mobile Cardiac Telemetry (MCT) is evolving on the forefront of all ambulatory cardiac monitoring technologies. MCT represents one of the most useful diagnostic tools available in Cardiology moving far ahead of other cardiac monitoring modalities. MCT is unique because as it automatically detects and transmits abnormal ECG activity via cellular technology in real time. Not only is MCT a great diagnostic tool, it also represents a great investment opportunity. Our goal is to share one of the industry’s best kept secrets.…Mobile Cardiac Telemetry reimbursement!
Limited Use of Mobile Cardiac Telemetry
With such a great diagnostic tool available, why is Mobile Cardiac Telemetry underutilized by most physicians? One key consideration for this can be attributed to the current reimbursement model employed by many of the ‘giants’ in the industry. Currently, the reimbursement structure in employed by the traditional service companies provides virtually ‘no’ compensation for the referring physician for their time required for Mobile Cardiac Telemetry (MCT). Under the current service model, the referring physician is only compensated for the professional (interpretation) component which requires ’24-hour availability and response’ each day for up to 30 days to monitor cardiac events.
To put into greater perspective, this means a physician must be ‘available’ 24 hours a day, for a duration of up to 30 days for a reimbursement. This equates to less than $1 per day. With this being the case, it is clear why Mobile Cardiac Telemetry is so grossly underutilized despite the prognostic value of MCT technology.
Further, we have discovered that most clinicians are unaware of the use of Mobile Cardiac Telemetry (today’s new version of cardiac event monitoring). When many doctors think of cardiac event monitoring or MCT, they think it requires to be performed exclusively by a cardiologist or an external ECG laboratory. This is simply not true.
MCT & Event Monitoring has also been traditionally perceived to be an ambulatory cardiac monitoring (AECG) monitoring modality that is used only when nothing is found with traditional 24 hour Holter monitoring. Although it is true to be used in this instance, many clinicians are also under the impression that these long term AECG monitoring studies require significant time & responsibility for each study. Physicians often use Mobile Cardiac Telemetry after they have exhausted nearly all other traditional diagnostic tools (such as resting 12-Lead EKG & Holter Monitoring) even in cases where MCT is the preferred diagnostic method.
The traditional ‘service model’ for MCT consists of two components:
- Technical Component – goes to the service company
- Professional Component – goes to the interpreting physician
To those in the industry, it is no secret that the technical analysis is (virtually) always the highest reimbursing component for all medical diagnostics. This holds true for Holter Monitoring, Cardiac Event Monitoring, Echocardiography, Nuclear Imaging, Vascular Diagnostics and Mobile Cardiac Telemetry. The primary reason for this is because the technical component requires significantly greater costs including specialized education & training for staff, labor costs, equipment costs, maintenance costs, supply costs and the time required to generate the final results of the study.
Solution: New Model for Mobile Cardiac Telemetry Reimbursement
For many medical doctors, there are alternative solutions available to increase the return with Mobile Cardiac Telemetry. If you look outside the traditional service model, there is another reimbursement structure that is emerging to more appropriately compensate professional clinicians for the time & cost required to properly administer and acquire Mobile Cardiac Telemetry (MCT) reimbursement in their medical facilities.
In order to qualify for all of the eligible Mobile Cardiac Telemetry reimbursement, each medical facility must meet the criteria identified in the technical component of the reimbursement structure. According the Medicare / CMS Guidelines for AECG monitoring, the technical component for Mobile Cardiac Telemetry reimbursement includes the time & cost of the patient hook up, patient education (about the study), analysis of the transmitted ECG, reporting, medical charting, equipment, maintenance and supply costs needed for each study.
Generally speaking, if a medical facility is willing to invest in the additional responsibilities listed above, then the medical facility can qualify for the complete reimbursement of the technical component. This may seem like a significant increase in responsibility, but most medical facilities are accustomed to performing the hookup, providing patient education, supplies and equipment & maintenance costs for other forms of ambulatory cardiac monitoring such as Holter or Event Monitoring. The 24/7/365 coverage, analysis, & report generation can be outsourced to an accredited Mobile Cardiac Telemetry diagnostic laboratory in exchange for the service fee. The cost from the diagnostic IDTF laboratory is (generally) less as the diagnostic laboratory does not incur the costs assumed by the medical facility for the technical component (equipment costs, maintenance, education, supplies, hook up etc.)
Mobile Cardiac Telemetry Reimbursement Summary
Mobile Cardiac Telemetry is proven to be a useful diagnostic tool to expedite time to diagnosis while reducing overall healthcare costs. Mobile Cardiac Telemetry (MCT) technology represents a greater advantage to patients, physicians and other medical professionals.
For more detailed information, Download our Mobile Cardiac Telemetry Reimbursement Guide on the top right side of the page. Our guide provides all the CPT Codes, description of coverage, Indications of use, and requirements to increase revenue with Mobile Cardiac Telemetry.
Other Resources:
- Download ACC / AHA Guidelines for AECG Monitoring
- CMS Guidelines for Ambulatory Electrocardiographic (AECG) Monitoring
**Disclaimer: This information is based on CMS Guidelines and subject to change. We always advise you always seek professional billing counsel to for legal guidance. See Terms & Conditions.
