2025 CPT code 93016
(Active) Effective Date: N/A Revision Date: N/A Cardiovascular - Cardiography Procedures Cardiovascular Procedures Feed
Cardiovascular stress test; physician supervision only, without interpretation and report.
Modifiers 26 and TC are not applicable to this code because it only represents the professional component. Other modifiers may be appropriate depending on the circumstances of the service.
Medical necessity for a cardiovascular stress test is typically established by the presence of symptoms suggestive of coronary artery disease (e.g., chest pain, shortness of breath), risk factors for CAD, or need for risk stratification before surgery or other procedures.
The physician's clinical responsibility involves overseeing the patient's safety and well-being during the stress test, monitoring vital signs and the ECG tracing to ensure there are no immediate complications.The physician does not interpret the results or generate a report.
In simple words: This code covers the doctor's time spent watching over a patient during a heart stress test (using exercise or medicine). The doctor doesn't analyze the test results or write a report; that's billed separately.
This CPT code represents the physician's supervision of a maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress test.It specifically excludes interpretation and report generation; these are billed separately. The physician oversees the patient's safety and monitors the ECG tracing during the test.
Example 1: A 60-year-old male patient with chest pain undergoes a treadmill stress test. The physician supervises the test, monitors the ECG and blood pressure, and ensures the patient's safety. Code 93016 is reported for the physician's supervision., A 55-year-old female patient with hypertension has a pharmacological stress test using dobutamine. The physician monitors the patient's response to the medication, watches the ECG tracing, and manages any adverse reactions.Code 93016 is billed for the supervision., A 70-year-old patient with known coronary artery disease is unable to tolerate treadmill exercise. A bicycle stress test is performed under the physician's supervision.Code 93016 is used for the physician's oversight during this procedure.
* Physician's order for the stress test.* Documentation of the type of stress test performed (treadmill, bicycle, pharmacological).* Record of vital signs (blood pressure, heart rate) throughout the test.* ECG tracing during the test.* Note indicating that the physician provided supervision only, without interpretation and report.
** This code should be used carefully to ensure that it accurately reflects the physician's role and level of involvement in the cardiac stress test.Incorrect coding may lead to claim denials.
- Revenue Code: T2B (Other Tests - Cardiovascular Stress Tests)
- RVU: The RVUs for this code vary depending on geographic location and other factors.It is a professional component only code, and modifiers 26 and TC cannot be used.
- Payment Status: Active
- Modifier TC rule: Modifier TC (Technical Component) is not applicable.
- Fee Schedule: Fee schedules vary by payer and geographic location; consult your payer's fee schedule for the most current information.
- Specialties:Cardiology
- Place of Service:Office, Hospital Outpatient, Ambulatory Surgical Center