Carelon Considers Add-on Ablation Code 93657 Not Medically Necessary  

Effective March 1, 2026, Carelon Medical Benefits Management, a utilization management company for Anthem BC/BS, will update clinical guidelines for additional linear or focal intracardiac catheter ablation (CPT 93657) of the left or right atrium for treatment of atrial fibrillation (AF), performed at the time of pulmonary vein isolation (PVI).  The coverage change will designate 93657 as not medically necessary.

In a written letter, HRS expressed significant concern about the clinical inappropriateness of the proposed policy, which would categorically restrict coverage, and compromise treatment for patients.