`S9025` Omnicardiogram/cardiointegra

Omnicardiogram/cardiointegram

Medicare coverage: Not payable by Medicare
Status: active (October 2026 file)

Medicare pricing for S9025

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S9025

Payer coverage policies that name S9025

S9025 appears in 3 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Capital Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Obsolete and Unreliable Tests and Procedures (0438)	not covered	Jul 16, 2026	payer document
Blue Cross & Blue Shield of Rhode Island	Cardiointegram	not covered	Jul 1, 2026	payer document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Cardiac	listed, no stance	Sep 1, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

ND: $0.00 (physician), effective Aug 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.

S9025 Omnicardiogram/cardiointegra