Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only

CPT 93016 is the billing code for "Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharmacological stress; supervision only". For cardiovascular stress test supervision only without interpretation

Medicare pays approximately $20.05 for CPT 93016 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 93016 has a total RVU of 4.45, broken down as: Work RVU 1.50, Practice Expense RVU 2.80, and Malpractice RVU 0.15. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 93016 include: Indication for stress test; Type of stress used; Patient monitoring during test; Any complications. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 93016: Includes supervision only. Interpretation coded separately Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 93016 include: TC (Technical component only), 59 (Distinct procedural service if performed separately), 52 (Reduced services if procedure not completed). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 93016 is 20-40 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.