Payer PolicyActive
Signal-Averaged Electrocardiography (SAECG) and Artificial Intelligence Algorithmic Electrocardiogram for Cardiovascular-Related Diseases
AETNA-CPB-0664
Aetna
Effective: March 16, 2023
Updated: December 6, 2025
created · Dec 2, 2025
Policy Summary
Aetna excludes signal‑averaged ECG, remote algorithmic ECG analysis (e.g., Premier Heart MCG/3DMP), and assistive AI algorithmic ECG devices (e.g., MyoVista) for cardiovascular disease detection because clinical value and improvement in outcomes have not been established. Key requirement: insufficient evidence/prospective outcome data to support use; CPT codes +0764T, 0765T, and 93278 are specifically not covered for the listed indications.
Coverage Criteria Preview
Key requirements from the full policy
"None — Aetna considers the following procedures experimental and investigational because the effectiveness of these approaches has not been established (therefore not covered): • Signal-averaged ..."
Sign up to see full coverage criteria, indications, and limitations.