Does Medicare Cover Home Blood Pressure Monitors?Posted by Medicare Made Clear
Medicare covers a device called an ambulatory blood pressure monitor for use once a year when ordered by a doctor. It does not cover regular “cuff” blood pressure monitors except for people undergoing dialysis at home.
What is an Ambulatory Blood Pressure Monitor?
An ambulatory blood pressure monitor (ABPM) is a device that measures and stores blood pressure readings at intervals throughout the day and night. The device includes a cuff that you wear on your arm and a recording device that you attach to your belt or clothing. You wear the device for a full 24 or 48 hours while going about your normal daily routine. You wear it while you’re awake and while you sleep.
Why Would an Ambulatory Blood Pressure Monitor Be Used?
An ABPM gives a more accurate picture of blood pressure than just one reading can provide. A single reading taken in the doctor’s office gives a snapshot of the blood pressure in that moment. However, blood pressure levels go up and down depending on the time of day, activity levels, emotions and other factors. With an ABPM, doctors can see blood pressure levels throughout the day and night.
When Would a Doctor Recommend an Ambulatory Blood Pressure Monitor?
A doctor may recommend an ABPM if he or she suspects one of the following:
- White coat syndrome. This is when blood pressure readings are high in the doctor’s office but mostly in the healthy range at other times.
- Masked hypertension. This is when blood pressure readings are in the healthy range in the doctor’s office but mostly high at other times.
If the readings stored in the ABPM are mostly high, then the doctor may diagnose high blood pressure, also called hypertension.
How Much Will Medicare Pay for an Ambulatory Blood Pressure Monitor?
Medicare Part B pays 80 percent of the Medicare-approved amount to rent an ABPM. You are responsible for the remaining 20 percent. Make sure the device comes from a Medicare-certified medical equipment supplier. Other suppliers may charge more than the Medicare-approved amount, and you could end up owing the additional cost.
Medicare Advantage plans (Part C) cover ABPMs, too. Contact your plan provider to find out what your costs would be.
What Numbers Are Considered High Blood Pressure?
A blood pressure reading that’s over 130/80 is considered high. Even if just one of the numbers is over that level – the upper number or the lower number – the reading is still high.
Usually, multiple high readings are needed for hypertension to be diagnosed. ABPMs give doctors the information they need to make a diagnosis when in-office blood pressure readings aren’t enough.
For more information about Medicare, explore MedicareMadeClear.com or contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
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