Why would my GP order a Holter monitor?

The most common reasons are: investigating palpitations (a fluttering, racing, or irregular heartbeat sensation), unexplained fainting or near-fainting (syncope or presyncope), dizziness or light-headedness that may be cardiac in origin, and monitoring for arrhythmias after cardiac surgery. The test is particularly useful for symptoms that don't happen every day — the longer the recording, the more likely an episode will be captured.

Can a GP clinic do Holter monitoring and bill Medicare?

GP clinics can fit the Holter device on-site and may have arrangements with cardiologists or physician groups for remote reporting. However, the MBS items for ambulatory ECG monitoring (11716, 11717, 11723, 11735) are restricted to specialist or consultant physicians — a GP cannot bill these items under their own provider number. The Medicare benefit is paid to the specialist who interprets and produces the formal report. In practice, many GP clinics operate as the application site and the cardiologist provides the report and bills Medicare. Patients should clarify billing arrangements with their clinic before the test.

What is the difference between a Holter and an event monitor?

A Holter monitor records continuously for 24 hours to 7 days. It captures everything but is most useful when symptoms occur frequently. An event monitor (or loop recorder) is worn for longer — days to weeks or months — and the patient activates a button when they experience symptoms. It records a snapshot before and after activation. Event monitors are better for symptoms that occur infrequently. The choice depends on how often your symptoms occur.

Does Medicare cover Holter monitoring in Australia?

Yes. MBS item 11716 covers continuous ambulatory ECG recording for 12 or more hours by a specialist or consultant physician. The Medicare fee is $200.55 and Medicare pays 85% ($170.50). A referral or request from a GP is required. The specialist must interpret the recording and produce a formal report. Once per 4-week period.

What Is a Holter Monitor? ECG Monitoring Explained

📋 Sources: MBS Online items 11716, 11717, 11723, 11735 and rule DR.1.1 (July 2026). Fees current as at July 2026 — verify at mbsonline.gov.au. NHS England cardiology guidance. Cardiac Society of Australia and New Zealand (CSANZ).

What is it?

A Holter monitor is a small portable device that continuously records your heart's electrical activity (ECG) while you go about your normal daily life. Sticky electrode patches are placed on your chest and connected by wires to a recorder about the size of a smartphone — worn clipped to your waistband or as a chest patch.

Unlike the brief ECG done in a clinic, a Holter captures your heart rhythm over hours or days — including during activities, stress, sleep, and any symptomatic episodes that may occur. It was named after biophysicist Norman Holter who developed the technique in the 1950s.

Why would my GP order this?

Common reasons:

Palpitations — a racing, fluttering, pounding, or irregular heartbeat sensation. Very common and often benign, but occasional episodes can indicate arrhythmia.
Syncope or presyncope — unexplained blackouts, fainting, or near-fainting. May be cardiac or non-cardiac in origin — Holter helps identify or exclude a heart rhythm cause.
Dizziness or light-headedness — particularly if episodes are associated with exertion or a rapid heart rate.
Known or suspected AF — detecting intermittent (paroxysmal) atrial fibrillation that may not be present during a clinic ECG.
Post-cardiac surgery surveillance — monitoring for arrhythmias after procedures known to carry dysrhythmia risk.

Types of ambulatory ECG monitoring

The right type depends on how frequently your symptoms occur.

Standard Holter — continuous 24–48 hrs MBS 11716

Continuous recording for at least 12 hours (usually 24–48 hrs). Best for symptoms occurring at least every few days. Records everything automatically — no patient activation needed. Requires full disclosure printout capability and microprocessor scanning analysis.

Fee: $200.55 · Medicare 85% = $170.50 · Once per 4 weeks · Specialist/physician only

Extended event monitor — up to 30 days MBS 11717

Patient-activated device worn for 7–30 days. Patient presses a button when symptoms occur — records 20 seconds before and 15 seconds after each activation. Better for infrequent symptoms that a 24-hour Holter is likely to miss. Includes transmission, analysis, and formal report.

Fee: $114.85 · Medicare 85% = $97.65 · Once per 3 months · Specialist/physician only

Short-term event monitor — up to 7 days MBS 11723

Patient-activated memory device worn for up to 7 days. For investigation of recurrent syncope, palpitation, or suspected arrhythmia when episodes occur somewhat infrequently. Same activation mechanism as 11717 but shorter wear period.

Fee: $60.60 · Medicare 85% = $51.55 · Once per 3 months · Specialist/physician only

AI-enabled 7-day monitor MBS 11735

Intelligent microprocessor-based device for 7 days with real-time ECG analysis, alerts, and daily/live data uploads. Patient triggered. For suspected arrhythmia or syncope, including in patients post-stroke, TIA, or at risk of cerebrovascular accident.

Fee: $149.25 · Medicare 85% = $126.90 · Max 4 times per year · Specialist/physician only

⚠️ Important — Medicare billing for GP clinics

All ambulatory ECG items (11716, 11717, 11723, 11735) are restricted to specialist or consultant physicians. A GP cannot bill these items under their own provider number — even if the GP fits the device on-site.

Under MBS rule DR.1.1, the service must be either:

Referred to a specialist or consultant physician by a requesting practitioner (GP); or
Requested by a requesting practitioner — i.e. the GP requests the test, the specialist performs/reports it.

How GP on-site Holter works in practice: Many GP clinics fit the Holter device and have a formal arrangement with a cardiologist or physician group for remote reporting. The cardiologist receives the raw data, interprets it, produces a formal report, and bills Medicare (11716 or similar) under their own provider number. The GP bills a standard consultation for the fitting appointment.

If a GP clinic is billing Holter items directly under a GP provider number, this does not comply with MBS rules. Clinics should ensure their arrangement is structured correctly — the interpreting physician bills the monitoring item, the GP bills the consultation.

What to expect wearing the monitor

Electrode patches are placed on your chest — usually 5–7 sticky pads with wires leading to the recorder. Takes about 10–15 minutes to fit.
Wear it continuously. You can shower with modern waterproof models — ask your clinic. Traditional monitors must stay dry.
Keep a symptom diary — note the time and what you were doing whenever you feel palpitations, dizziness, or other symptoms. This is critical for matching your symptoms to the ECG trace.
Continue normal activities. The point is to record your heart during real life — exercise, work, sleep. Avoid strong magnets and MRI scanners.
Return the device at the agreed time. Results typically take a few days and are discussed at a follow-up appointment with your GP or cardiologist.

What do the results show?

The report from the cardiologist will document:

Minimum, maximum, and average heart rate over the recording period
Any abnormal rhythms — AF, SVT, ectopic beats, heart block, pauses
Correlation between symptoms and rhythm — did your palpitation episode correspond to an arrhythmia, or was the rhythm normal during symptoms?
Frequency of ectopic beats — isolated ectopics are very common and often normal; a high burden may need further review

A normal Holter during a symptomatic episode is clinically useful — it rules out a cardiac arrhythmia as the cause of those symptoms. A normal Holter without any symptoms during the recording period is less informative — it may mean your GP recommends a longer monitoring period.

Coverage by country

🇦🇺 Australia — MBS items 11716, 11717, 11723, 11735

All items require specialist/consultant physician billing. GP refers → specialist reports → Medicare benefit paid to specialist (85% of schedule fee). GP bills standard consult for the fitting/results appointment. No separate MBS item for GP to bill Holter fitting alone. Verify current fees at mbsonline.gov.au.

🇬🇧 United Kingdom — NHS

Holter monitoring is available free on NHS when referred by a GP. Usually performed at a cardiology department or community cardiac monitoring service. Some areas use GP-practice-based fitting with central reporting. Typically reported within 1–2 weeks. No cost to patient.

🇳🇿 New Zealand

Available through cardiology referral. Subsidised under Health NZ. Community-based Holter services exist in some areas. GP may refer directly to a cardiac monitoring service. Co-payment may apply at GP level; hospital-based monitoring is generally free.

🇨🇦 Canada

Covered under provincial health insurance when referred by a physician. Usually performed through cardiology or community cardiac monitoring services. No out-of-pocket cost for the monitoring itself. Availability of community-based Holter services varies by province.