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The rules say that plans must pay for a medical service or item if regular Medicare would pay for it in this case. 
You can find this rule at 42 Code of Federal Regulations (CFR) Section 422.101. 
 
The rules say that cardiac event monitors without transtelephonic capability must be removed from the patient 
and taken to a location for review of the stored electrocardiogram (EKG) data. Some devices also permit a 
"time sampling" mode of operation. The "time sampling" mode is not covered under ambulatory EKG 
monitoring technology. Some cardiac event monitoring devices with trans-telephonic capabilities require the 
patient to dial the phone number of a central EKG data reception center and initiate transmission of EKG data. 
Other devices use Internet-based in-home computers to capture and store EKG data. When such devices detect 
pre-programmed arrhythmias, data is automatically sent via modem and standard telephone lines to a central 
receiving center, or independent diagnostic testing facility (IDTF), where the data is reviewed. Internet-based 
in-home computer systems may also provide the receiving center with a daily computer-generated report that 
summarizes 24 hours of EKG data. 
 
Certain cardiac event monitors capture electrical activity with a single electrode attached to the skin. Other 
devices may employ multiple electrodes in order to record more complex EKG tracings. Additionally, devices 
may be individually programmed to detect patient-specific factors, electrode malfunction, or other factors. 
Cardiac event monitors can be further categorized as either pre-event or post-event recorders, based on 
their memory capabilities: 
 
Pre-symptom Memory Loop Recorder (MLR) 
 
Upon detecting symptoms, the wearer presses a button, which activates the recorder to save (i.e., memorize) an 
interval of pre-symptom EKG data along with data during and subsequent to the symptomatic event. Self-
sensing recorders (also known as event-activated or automatic trigger) do not require patient input to capture 
these data. Single or multiple events may be recorded. The device is worn at all times, usually for up to 30 
days. 
 
Implantable (or Insertable Loop) Recorder (ILR) 
Another type of pre-symptom MLR, it is implanted subcutaneously in a patients upper left chest and may 
remain implanted for many months. An ILR is used when syncope is thought to be cardiac-related but is too 
infrequent to be detected by either a HolterTM monitor or a traditional pre-symptom MLR. Post-symptom Recorder 
 
The patient temporarily places this device against the chest when symptoms occur and activates it by pressing a 
button. These recorders represent old technology, as they do not include a memory loop. The device transmits 
EKG data telephonically in real-time and is usually used for up to 30 days. 
 
You can find these rules in the National Coverage Determination (NCD) Electrocardiographic Services 20.15. 
 
If you want to read these Medicare rules, you can go to this website www.medicareappeal.com. 
 
The Plan contract says that the Plan covers items and services in accordance with Medicare rules.