The proposal would increase access to ambulatory blood pressure monitoring by expanding coverage to more applications of the test.
The Centers for Medicare and Medicaid Services (CMS) today proposed an update to its national coverage policy for ambulatory blood pressure monitoring (ABPM).
ABPM is a non-invasive diagnostic test that uses a device to track blood pressure over 24-hour cycles and allows blood pressure to be measured over full days instead of just at a single moment in time.
“Today’s proposal to expand coverage of (ABPM) is supported by many years of evidence and would help ensure that beneficiaries have their blood pressure measured accurately, so they can receive the care that is best for them,” said CMS Administrator Seema Verma.
The diagnostic test could measure blood pressure more accurately, leading to the diagnosis of high blood pressure in patients who would not have been identified as having the condition.
Currently, national coverage for ABPM covers the test only for patients with suspected “white coat hypertension,” which occurs when a patient’s anxiety from being in a clinical setting causes a spike in blood pressure beyond what occurs outside the clinical setting.
CMS is proposing to update the current national coverage to expand access to ABPM to include coverage for cases of suspected “masked hypertension,” which occurs when blood pressure measurements in a doctor’s office are lower than measurements outside of the office.
“With the prevalence of chronic diseases — including high blood pressure — increasing among Medicare beneficiaries, it is critical that our agency closely monitor the evidence for interventions that could improve health outcomes for patients with these conditions,” Verma said.
For eligible patients, ABPM is covered once per year.
The agency is seeking public comments about the proposal. The 30-day comment period begins on April 9.
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