Summary & Overview
CPT 93790: Ambulatory Blood Pressure Monitoring, 24-Hour Interpretation
CPT code 93790 covers ambulatory blood pressure monitoring (ABPM) in which a patient wears an automated device that records blood pressure at intervals over a 24‑hour period and the provider interprets and reports the results. This code is nationally relevant as ABPM is the reference standard for diagnosing white‑coat and masked hypertension, assessing blood pressure variability, and guiding treatment decisions in outpatient cardiovascular care.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for ABPM, the typical outpatient service flow, and the types of benchmarks and policy considerations that influence coverage and utilization. Content highlights include coding and billing context for ABPM services, typical sites of service and clinical indications, and the kinds of payer policies and reimbursement practices that are commonly encountered nationally.
This publication provides practical reference material for billing managers, clinicians, and policy analysts seeking a national perspective on use and coverage of ambulatory blood pressure monitoring. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 93790 describes the prescription, monitoring, recording and interpretation of ambulatory blood pressure monitoring (ABPM) in which a patient wears a device continuously that automatically measures blood pressure at intervals over a 24‑hour period and records the results. The provider interprets the recorded data and reports findings.
Service type: Diagnostic ambulatory monitoring and interpretation
Typical site of service: Outpatient clinic or ambulatory care setting, with the device worn by the patient in the community over a 24‑hour period before return for data retrieval and interpretation.
Clinical & Coding Specifications
Clinical Context
A 52-year-old patient with treated hypertension and reported elevated office readings is referred for ambulatory blood pressure monitoring. The primary care provider prescribes a 24-hour ambulatory blood pressure monitor to obtain multiple daytime and nighttime measurements while the patient performs usual activities. The device is applied in the clinic or sleep lab, programmed to record blood pressure every 15–30 minutes during daytime and every 30–60 minutes at night. The patient returns the device the next day; the provider downloads, reviews, and interprets the 24-hour recording for assessment of white-coat hypertension, masked hypertension, blood pressure variability, and nocturnal dipping status. A written report documents average daytime and nighttime values, percent time above threshold, and clinical interpretation with recommendations documented in the medical record.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing separately for interpretation and report by the physician distinct from the technical device service |
TC | Technical component | Use when billing the technical portion only (device, recording, data collection) |