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What CMS says about PT/INR self-testing

In a 2001 Decision Memoradum, Medicare cites clinical evidence supporting Coumadin self-testing on a weekly basis. The Centers for Medicare and Medicaid (CMS) concluded:

  •  The studies reviewed demonstrated home PT/INR monitoring significantly improves time in therapeutic range for select groups of patients, compared to testing done in physician offices or anticoagulation clinics.

  • Increased time in therapeutic range leads to improved clinical outcomes, with reductions in thromboembolic and hemorrhagic events.

  • In order to achieve time in therapeutic range of 90%, a patient most likely needs to be tested once a week.

(CMS Decision Memorandum #CAG-00087N September 18, 2001)


Click here to read and/or download a copy of the CPT codes and additional information from CMS.