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For what indications does Medicare reimburse for a Cardiovascular/Exercise Stress Test?

The indications are as follows:

  • To determine the location, presence and severity of exercise induced myocardial ischemia
  • Evaluate potential for rhythm disturbances
  • Evaluate hemodynamic responses to activity
  • Evaluate the effect of medical or interventional therapy
  • Prescribe appropriate activity guidelines
  • Pre-operative evaluation of patients at high risk for coronary artery disease who are scheduled to undergo general anesthesia and/or undergo a surgical procedure which places them at risk for a sudden cardiac event.
  • Establish prognosis and management decisions following an uncomplicated myocardial infarction.
  • Determine whether underlying coronary artery disease is the etiology of unexplained left ventricular dysfunction
  • Assess for recurrent ischemia in patients with prior percutaneious intervention who are at increased risk for restenosis.

What is the amount of reimbursement?

The rates for reimbursement can vary by geographical region, insurance company policies, and patient conditions. It is important that you contact your Medicare contractor to verify reimbursement amounts for your region.

What are the CPT and ICD-9 codes for a Cardiovascular/Exercise Stress Testing?

Click here to download the full list.

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