Holter Monitors

This policy covers ambulatory Holter monitoring (continuous ambulatory ECG) for 24–48 hours to evaluate cardiac arrhythmias and related symptoms — e.g., unexplained syncope/near‑syncope, dizziness, recurrent palpitations, chest pain, suspected transient atrial fibrillation/flutter after neurologic events, cardiomyopathies, prolonged QT/Brugada syndromes, pacemaker/ICD evaluation, post‑ablation assessment, and other established adult indications, with limited pediatric (<18) criteria. Coverage is limited to 24–48 hour monitoring using FDA‑approved Holter devices, monitoring beyond 48 hours is subject to separate criteria, findings must be interpreted in clinical context and not used as the sole therapeutic guide, and prior authorization/frequency limits or other utilization rules may apply.

"Continuous Holter monitoring for 24–48 hours for patients with daily or near-daily unexplained symptoms."