CPT 0765T: AI-Enhanced ECG Analysis for Cardiac Assessment

CPT code 0765T defines an artificial intelligence–enhanced analysis of data from a previously performed electrocardiogram (ECG) to assess patients for cardiac abnormalities. As AI-driven diagnostic tools proliferate, this code formalizes reporting for algorithmic ECG assessment and supports consistent billing and tracking of these services nationally. The code is relevant to clinicians, billing teams, health systems, and payers as adoption of AI in diagnostic workflows grows.

Key payers considered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical service captured by the code, the typical sites of service where it applies, and a summary of common billing modifiers and operational considerations. The publication outlines benchmarking and reimbursement context when available, notes policy developments affecting AI-enabled diagnostic codes, and summarizes clinical context for appropriate use of algorithm-based ECG interpretation. This material is intended to help coding staff, revenue cycle teams, and clinical leaders understand the role of CPT code 0765T within modern cardiac diagnostic workflows and payer interactions.

Billing Code Overview

CPT code 0765T describes the use of algorithms, enhanced by artificial intelligence, to analyze data from a previously performed electrocardiogram (ECG) to assess a patient for cardiac issues. This service represents an AI-assisted ECG interpretation and risk-assessment workflow.

Service type: Diagnostic algorithm / AI-enhanced ECG analysis
Typical site of service: Ambulatory care settings, outpatient clinics, cardiology practices, and other locations where ECGs are performed and reviewed

Clinical Context

A 68-year-old male with a history of hypertension and prior myocardial infarction presents for routine cardiology follow-up and reports mild exertional dyspnea. A resting 12-lead electrocardiogram (ECG) was obtained in clinic earlier that day. The cardiology practice uses an AI-enhanced algorithm to analyze previously acquired ECG data to screen for arrhythmia, ischemia patterns, conduction delays, and left ventricular dysfunction indicators. The workflow: the clinic uploads the digital ECG file or imports it from the electronic health record into the AI analytic platform; the platform runs validated algorithms and generates a structured report highlighting flagged abnormalities (for example, atrial fibrillation probability, QRS morphology changes, or low ejection fraction predictions). A licensed provider (cardiologist, electrophysiologist, or advanced practice clinician under appropriate supervision) reviews the AI-derived assessment, correlates findings with clinical exam and prior studies, documents interpretation and clinical decision-making in the medical record, and uses the results to determine next steps (additional testing, medication changes, or referral). Typical site of service is an outpatient cardiology clinic, ambulatory diagnostic testing center, or hospital outpatient department where previously performed ECG data are available for analysis.

Coding Specifications

Modifier	Description	When to Use
`22`	Increased procedural services	Use when the AI analysis required substantially greater work, documentation supports increased complexity beyond typical time and effort.

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiology	Cardiologists commonly review AI-ECG outputs and integrate findings into management.
207RN0400X	Clinical Cardiac Electrophysiology	Electrophysiologists interpret rhythm abnormalities and validate AI arrhythmia detections.
363A00000X	Nurse Practitioner - Cardiology	Advanced practice clinicians in cardiology clinics review AI results and document clinical decisions.
207P00000X	Internal Medicine	Hospitalists and internists in outpatient settings may order and review AI-ECG analyses when managing cardiac risk.
2084P0800X	Physician Assistant - Cardiology	PAs in cardiology practices participate in reviewing AI-derived ECG assessments and documentation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I48.91`	Unspecified atrial fibrillation	AI-ECG algorithms commonly screen for atrial fibrillation and other atrial arrhythmias from prior ECG tracings.
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	AI analysis may detect ischemic patterns or historical changes prompting further ischemic evaluation.
`I50.9`	Heart failure, unspecified	AI-derived ECG markers can suggest reduced ejection fraction or conduction abnormalities relevant to heart failure screening.
`R00.2`	Palpitations	Patients presenting with palpitations often have prior ECGs analyzed by AI to evaluate rhythm disturbances.
`I44.2`	Atrioventricular block, complete	Conduction abnormalities detectable on prior ECGs are routinely assessed by AI algorithms.
`R07.9`	Chest pain, unspecified	ECGs obtained for chest pain are commonly reanalyzed with AI tools to augment detection of ischemia or rhythm issues.
`Z13.6`	Encounter for screening for cardiovascular disorders	Asymptomatic screening ECGs may be analyzed by AI to identify occult cardiac disease.
`I73.9`	Peripheral vascular disease, unspecified	Vascular disease patients often undergo cardiac risk assessment where AI-ECG may be applied.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93000`	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report	Represents the original ECG acquisition and interpretation that provides source data for the AI-enhanced analysis billed with `0765T`.
`93010`	Electrocardiogram interpretation and report only	Used when only interpretation of a previously recorded ECG is performed; may be used in conjunction with or instead of AI analysis depending on documentation and payer rules.
`93018`	Rhythm analysis, first 30 days; auto or noninvasive continuous ECG monitoring	Related when ambulatory rhythm monitoring provides source tracings later analyzed by AI tools for extended rhythm evaluation.
`93268`	External mobile cardiovascular telemetry with report and physician review	When telemetry or mobile cardiac monitoring data are processed and AI algorithms are applied to previously recorded rhythm strips; reflects extended monitoring workflow.
`99457`	Remote physiologic monitoring treatment management services, first 20 minutes	Related in settings where AI-ECG outputs inform remote monitoring care management and provider time is spent interpreting results and managing the patient.
`0500T`	Electrocardiographic screening using AI (example legacy tracking code)	Other technology-specific or temporary technology CPT codes may be used in parallel or historically; shows the broader context of AI-enabled ECG services.

OpenPayer

Summary & Overview