Long-Term Ambulatory Cardiac Monitoring (Outpatient Cardiac Telemetry, Implantable Cardiac Rhythm Event Monitors, and Intracardiac Ischemia Detection Systems)

This policy covers long‑term ambulatory cardiac monitoring — including outpatient/mobile cardiac telemetry (OCT/MCT), implantable cardiac rhythm event monitors (ILRs), and related telemetry systems — for detection and evaluation of arrhythmias such as suspected or known atrial fibrillation (including after inconclusive ≥14‑day noninvasive monitoring), post‑ablation AF surveillance, monitoring after cryptogenic stroke, evaluation of syncope, palpitations, and other indications requiring prolonged rhythm surveillance. Coverage is subject to major limits and requirements: OCT/MCT is capped at 30 days per episode, ILRs are reimbursed only for specified clinical scenarios (cryptogenic stroke monitoring limited to patients ≥40 after a neurologist has completed and reviewed required diagnostics), prior ≥14‑day noninvasive monitoring is required for infrequent symptoms, and numerous devices/uses (e.g., Zio® Patch/XT, certain smartwatch systems, intracardiac ischemia detection systems) are considered experimental or excluded.