The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries under the following circumstances:.

SUBJECT: National Coverage Determination for Ambulatory Blood Pressure Monitoring interpreted by the treating physician or treating non-physician practitioner.įor eligible patients, ABPM is covered once per year.Ĭoverage of other indications for ABPM are at the discretion of the Medicare Administrative Contractors.ĭeputy Director, Coverage and Analysis Groupĭirector, Division of Policy and Evidence ReviewĪcting Director, Evidence Development Division.provided to patients with oral and written instructions and a test run in the physician’s office must be performed and.capable of producing standardized plots of blood pressure measurements for 24 hours with daytime and night-time windows and normal blood pressure bands demarcated.For beneficiaries with suspected masked hypertension, which is defined as average office blood pressure between 120 mm Hg and 129 mm Hg for systolic blood pressure or between 75 mm Hg and 79 mm Hg for diastolic blood pressure on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are ≥130/80 mm Hg.

For beneficiaries with suspected white coat hypertension, which is defined as an average office blood pressure of systolic blood pressure greater than 130 mm Hg but less than 160 mm Hg or diastolic blood pressure greater than 80 mm Hg but less than 100 mm Hg on two separate clinic/office visits with at least two separate measurements made at each visit and with at least two blood pressure measurements taken outside the office which are The Centers for Medicare & Medicaid Services (CMS) has determined that the evidence is sufficient to cover ambulatory blood pressure monitoring (ABPM) for the diagnosis of hypertension in Medicare beneficiaries under the following circumstances:

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