Signal-Averaged Electrocardiography (SAECG) / Artificial Intelligence Algorithmic Electrocardiogram for Detection of Cardiovascular-Related Diseases — CPB 0664 | AETNA Coverage Update

Aetna, a CVS Health company, modified CPB 0664 covering signal-averaged electrocardiography and AI algorithmic ECG technologies, effective December 9, 2025. Every procedure under this policy — including CPT 93278, add-on code +0764T, standalone code 0765T, and 0897T — carries an experimental or investigational designation. If your team bills any of these codes to Aetna, expect denials.

This policy update clarifies Aetna's position across a growing list of ECG-adjacent technologies. The Aetna SAECG and AI ECG coverage policy now explicitly names devices like the MyoVista Wavelet ECG, Premier Heart's Multifunction Cardiogram (MCG), and the vMap non-invasive arrhythmia analysis system — all non-covered. For cardiology billing teams and electrophysiology practices, this is a denial map worth keeping close.

Quick-Reference Table

Aetna SAECG and AI ECG Coverage Criteria and Medical Necessity Requirements 2025

The short version: there are no covered indications under CPB 0664. Aetna classifies every procedure addressed by this policy as experimental, investigational, or unproven.

That matters because it changes how you think about medical necessity documentation. You're not building a medical necessity case to get paid. You're building a record that explains why you billed — and documenting patient acknowledgment of non-coverage if you expect the patient to pay out of pocket.

Aetna's position is that the effectiveness of SAECG and AI-based ECG analysis has not been established. That language — "effectiveness has not been established" — is the standard phrase payers use when clinical evidence doesn't meet their threshold for routine coverage. It's a higher bar than "not medically necessary in this case." It means the technology itself doesn't pass, regardless of how clean your documentation is.

For AI-based ECG tools specifically, Aetna calls out two clinical applications as non-covered: detection and screening for acute coronary syndrome, and early detection of hypertension. These are arguably the two most commercially marketed AI-ECG use cases right now. The MyoVista device — billed under add-on CPT +0764T and standalone CPT 0765T — is named explicitly. If a vendor told your physicians this device would get covered, this policy is the answer to that conversation.

There are no prior authorization pathways listed under this policy because prior authorization is irrelevant when a service is categorized as experimental. Aetna won't authorize something it considers investigational. If your billing guidelines include a prior auth workflow for these codes, remove it — prior auth will not change the outcome here.

Aetna SAECG and AI ECG Exclusions and Non-Covered Indications

CPB 0664 lists five distinct technologies or procedures, all non-covered. Here's what each one means for your team.

Signal-averaged electrocardiography (CPT 93278) has been on Aetna's experimental list for years. This update reaffirms that position. SAECG analyzes late potentials in the cardiac signal to predict arrhythmia risk — a useful clinical concept, but one Aetna doesn't reimburse.

AI algorithmic ECG assessment via MyoVista (CPT +0764T and 0765T) uses wavelet ECG technology to evaluate cardiac dysfunction. The device has active marketing to cardiology practices. Aetna is not covering it. Bills for +0764T or 0765T under Aetna will be denied on the basis of experimental status.

Remote algorithmic analysis via Premier Heart's MCG (also called the 3DMP Computerized EKG System) is also explicitly excluded. This device has been marketed under several names over the years. Regardless of what it's called on the claim, the technology is non-covered.

vMap non-invasive arrhythmia analysis (CPT 0897T) is used in planning catheter ablation procedures. Aetna excludes it from coverage. This one is worth flagging specifically for electrophysiology practices — if you're using vMap to plan ablations and billing CPT 0897T, those claims will deny. The related ablation codes (CPT 93655 and 93656) are listed as contextually related codes, not covered under this policy, but they're not excluded by name here either.

Coverage Indications at a Glance

Aetna SAECG and AI ECG Billing Guidelines and Action Items 2025

CPT, HCPCS, and ICD-10 Codes for SAECG and AI ECG Under CPB 0664

Not Covered / Experimental CPT Codes

These codes are the core of CPB 0664. All carry an experimental, investigational, or unproven designation under Aetna's coverage policy.

Key ICD-10-CM Diagnosis Codes

These diagnosis codes appear in the CPB 0664 policy data. They reflect the cardiac conditions associated with the procedures addressed by this policy. Their presence in the policy does not create a covered pathway — all primary procedures remain experimental.