G654 – Technical component - 12 to 35 hours recording
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Provides the technical component for Level 2 continuous ECG (Holter) monitoring, which involves recording for a period of 12 to 35 hours. Level 2 monitoring is defined as using devices with fewer than three skin electrodes, or devices that only record portions of the monitoring period, or do not provide trend analysis. The service requires a minimum of 12 hours of monitoring. This fee code represents the recording aspect of the service, distinct from the scanning (G655) and professional (G653) components.
When to Use
- Use G654 when providing the technical recording component for a Level 2 Holter monitor (fewer than three electrodes or no trend analysis) that lasts between 12 and 35 hours.
- Bill G654 in conjunction with G655 for the scanning component and G653 for the professional interpretation component to complete the full Holter billing cycle.
Common Pitfalls
- Billing G654 for recordings under 12 hours, which will result in an automatic rejection as the minimum duration requirement is not met.
- Submitting G654 for Level 1 monitoring (three or more electrodes with trend analysis), which should instead be billed under G651.
- Failing to apply the 86.10% reduction when the technical component is performed within a hospital setting, as mandated by the payment adjustment rules.
Billing Tips
- Ensure the recording duration is clearly documented in the patient record to justify the 12-35 hour window required for G654 eligibility.
- Verify that the device used meets the Level 2 criteria (fewer than three electrodes) to avoid audit discrepancies when comparing against Level 1 codes like G651.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician has the necessary training and experience to personally render the technical component of the service.
The physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
Maximum one professional component, one technical recording component and one technical scanning component per patient, per recording.
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