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Comprehensive 15-22 Minute Testing Protocol


Protocol Duration: 15-22 minutes

Test Components: HRV Biofeedback + Vascular Assessment + Autonomic Function Testing

CA Reimbursement: $475-$550*


CPT Code Breakdown:

• 90875 - Psychophysiological therapy with biofeedback, 30 min ($120-$145)

• 93922 - Non-invasive extremity arterial studies, bilateral ($150-$180)

• 93923 - Complete bilateral noninvasive physiologic studies ($120-$140)

• 93050 - Arterial pressure waveform analysis ($85-$95)


Total Estimated Reimbursement: $475-$560 in California


Test Protocol Timeline:

0-7 Minutes: HRV + Respiration + GSR Biofeedback

7-12 Minutes: Bilateral ABI + TBI + Waveform Analysis

12-22 Minutes: Extended HRV Training + Autonomic Function Assessment


Medical Necessity Examples:

• Type 2 Diabetes with Peripheral Neuropathy (E11.42)

• Peripheral Vascular Disease (I73.9)

• Generalized Anxiety Disorder (F41.1)

• Autonomic Nervous System Disorder (G90.9)


*Reimbursement rates vary by payer and geographic location. California rates shown are typical ranges based on Medicare and major commercial payers.

Sample Procedures & Reimbursement Scenarios