National Coverage Analysis (NCA) Tracking Sheet

Ambulatory Blood Pressure Monitoring (ABPM)

CAG-00067R2

Issue

Ambulatory blood pressure monitoring (ABPM) is a non-invasive diagnostic test that uses a device to determine blood pressure over 24-hour cycles. In this way, blood pressure can be measured over time rather than discrete measurements that are usually obtained. These measurements are stored in the device and later interpreted.

Section 20.19 of the Medicare National Coverage Determination (NCD) Manual states the conditions of coverage for ABPM. CMS determined in 2001 that ABPM is covered only for those patients with suspected white coat hypertension, which is defined as: 1) office blood pressure >140/90 mm Hg on at least three separate clinic/office visits with two separate measurements made at each visit; 2) at least two documented blood pressure measurements taken outside the office which are < 140/90 mm Hg; and 3) no evidence of end-organ damage. ABPM is not covered for other uses.

CMS is soliciting public comment relevant to the request. We are particularly interested in comments that include scientific evidence and that address the breadth of the request

Benefit Category

Diagnostic Tests (other)

Requestor Information

Requestor Name Requestor Letter
John Warner, MD, FAHA. President, American Heart Association View Letter
N/A

Important Dates

Formal Request Accepted and Review Initiated
10/09/2018
Expected NCA Completion Date
07/08/2019
Public Comment Period
10/09/2018 - 11/08/2018
Proposed Decision Memo Due Date
Proposed Decision Memo Released
04/09/2019
Proposed Decision Memo Public Comment Period
04/09/2019 - 05/09/2019
Decision Memo Released
07/02/2019
Comments for this NCA
View Public Comments

Contacts

Lead Analysts
Stuart Caplan, RN, MAS
Lead Medical Officers
Joseph Hutter, MD, MA

Medicare Benefit Category Determination Date

Actions Taken

October 9, 2018

CMS initiates this national coverage analysis for Ambulatory Blood Pressure Monitoring. The initial 30-day public comment period begins with this posting date, and ends after 30 calendar days. CMS considers all public comments, and is particularly interested in clinical studies and other scientific information relevant to the topic under review.

Instructions on submitting comments can be found at: http://www.cms.gov/Medicare/Coverage/InfoExchange/publiccomments.html.

To submit a comment, please use the orange "Comment" button at the top of the page. Enter comments directly into the "Submit A Public Comment" webpage.

April 9, 2019

July 2, 2019

Posted final decision memo.