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Billing code

G649A — Continuous ECG monitoring (Holter) Level 1 – professional component – 14 or more days

Level-1 Holter reading, 14+ days

Bill G649 for personally interpreting Level 1 continuous ECG monitoring lasting 14 days or more.

Watch for: Payable once per 30 days per patient; the report must state channels, continuity, analysis type and device model.

Code

G649A

Description

Continuous ECG monitoring (Holter) Level 1 – professional component – 14 or more days

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Level 1 continuous ambulatory ECG (Holter-type) monitoring, professional component, for a recording of 14 or more days. Once per 30 days.

What it covers

G649 is the professional component of Level 1 continuous ECG monitoring (for example Holter) for 14 or more days (J16).

Level 1 needs a device that records three or more channels at once, captures every beat continuously with three or more skin electrodes, allows analysis and manual review of all parts of the recording, produces graphical and quantitative reports, and has a patient diary and event marker. Minimum 12 hours of monitoring (J16).

Billing rules

• Minimum 12 hours of monitoring; the device must meet the Level 1 definition (J16).
• Maximum one professional component, one technical recording component and one technical scanning component per patient, per recording (J16).
• For recordings over 36 hours, bill the code for that duration; don't bill multiples of shorter-duration codes (J17).
• The 14-days-or-more codes (G647, G648, G649, G694, G695, G696) are payable once per 30 days per patient (J17).
• External loop recorders that rely only on patient activation and can't analyze rhythm in real time are not insured (J17).
• The report must state the number of channels, whether the recording was continuous, whether analysis was real-time, post-hoc or both, and the device manufacturer and model (J17).
• You must personally interpret the results to bill the professional component (J1).

Often billed with

• G647 technical recording component for the same recording (J16).
• G648 technical scanning component for the same recording (J16).

Related codes: G647, G648, G694, G695, G696

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Electrocardiography (ECG) – Continuous ECG Monitoring, page J16; notes J17.

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