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National Coverage Analysis (NCA) Tracking Sheet for Ambulatory Blood Pressure Monitoring (CAG-00067R)

Ambulatory blood pressure monitoring (ABPM) is a diagnostic test used to measure blood pressure when isolated clinic blood pressure measurements are suspected to be inaccurate. ABPM is conducted under the supervision of a physician and does not entail patient intervention; it is not considered a self-monitoring device.

Medicare currently has a National Coverage Determination (NCD) on ABPM that covers the technology only for patients with suspected white coat hypertension. (Section 50-42 of the Coverage Issues Manual [CIM]). The CIM states that the 24-hour measurements collected by the ABPM "…are stored in the device and are later interpreted at the physician's office." However, the reference to the physician's office can be misleading. The intent of our policy was not that ABPM data be interpreted specifically in the setting of a physician's office, but rather that the data be interpreted by a physician, without specification of the setting.

Due to the potentially misleading language cited above, we will make a technical correction to Section 50-42 of the CIM to indicate that a physician is required to perform the interpretation of the data obtained from ABPM. The policy will not specify the setting in which the interpretation is performed.

Diagnostic Tests (other)
Requestor Name(s)Internal Request
Formal Request Accepted and Review Initiated11/12/2002
Expected NCA Completion Date02/13/2003
Public Comment Period12/12/2002 - 01/12/2003
Decision Memo Released01/16/2003
Lead Analyst(s)
  • Poppy S. Kendall, MHS

November 12, 2002

The Coverage and Analysis Group announces its intent to make a technical correction to CIM section 50-42.

January 16, 2003

The Centers for Medicare and Medicaid Services posts decision memorandum  announcing its intent to make a technical correction to CIM section 50-42.
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