All PlansCoverageMedium impact
EKG as part of annual exam reminder
Blue Cross Blue Shield of Rhode Island·RI · Family Medicine, Internal Medicine, General Practice +1 more·Physician
Effective date
Jul 1, 2019
We identified it
Jun 20, 2026
Summary
EKGs (CPT 93000) performed as part of annual wellness exams will not be separately reimbursed unless there is a documented medical diagnosis justifying the testing. This policy reinforces existing guidelines against routine EKG screening in asymptomatic, low-risk patients.
Action Required
Immediately: Billing team must verify medical necessity documentation before billing CPT 93000 with annual wellness exams. Update encounter forms to remind providers that EKGs require separate diagnostic justification beyond routine screening. Claims for routine EKGs without supporting diagnoses will be denied.