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Remote patient monitoring has gained popularity in the recent months, with medical practices wondering how remote patient monitoring is reimbursed. Since the first dedicated CPT code for remote patient monitoring launched in 2018, many more billing codes went into effect and cover a variety of care provided outside the medical setting.
If you are looking for the essential CPT codes for remote patient monitoring, here are the 5 you should know about:
CPT code 99453: monitoring device setup and education on its use
CPT code 99453 reimburses the provider for spending time with the patient and setting up a health monitoring device and educating the patient on its proper use. The device requirements are that the patient has an underlying condition to warrants a remote monitoring, the device is suitable for monitoring such a condition and that the device is a medical device validated for medical use. Typical devices that would fall under this category are blood pressure monitors and glucose meters that are quipt to transmit patient’s vitals electronically.
CPT code 99453 description: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.
CPT code 99454: remote patient monitoring with a device providing daily recordings or alerts
CPT code 99454 reimburses physicians, qualified healthcare professionals and clinical staff each 30 days for remotely monitoring patients using health tracking devices capable of sharing patient’s data recorded outside a medical setting electronically. Practitioners are reimbursed each 30 days for patients enrolled in a remote patient monitoring program who have been actively using such health tracking devices.
CPT code 99454 description: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.
CPT code 99457: remote patient monitoring, with patient communication
CPT code 99457 is a dedicated remote patient monitoring code that pays for the time clinical staff spends on patient care provided remotely. Code 99457 reimburses for the initial 20 minutes of such care during the month and is billed monthly. The definition of this code changed in January 2020 where before that it has covered all care time above 20 minutes. The CMS has recognized that some patients might require more time each month and has added a new code, reclassifying CPT 99457 as the “initial 20 minutes”, allowing providers to bill more each month.
CPT code 99457 description: “Remote physiologic monitoring treatment management services, initial 20 minutes of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.”
CPT code 99458: remote patient monitoring, with patient communication, additional time
CPT code 99458 was introduced in 2020 as an add-on code to CPT 99457. As explained above, CPT 99457 has been reclassified as the initial 20 minutes of care time in a month and CPT 99458 covers additional 20 minutes of patient remote care. This new code reimburses providers with patients who required at least 40 minutes of their time that month. CPT code 99458 is billed together with is base code 99457.
CPT code 99458 description: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes
CPT 99091: remote patient monitoring, collection and interpretation of data
CPT code 99091 pays physicians and other qualified healthcare professionals for remotely monitoring eligible patients. Patients need to use health monitoring devices capable of supporting remote monitoring of vitals and transmitting those real time and electronically to the care team. Care team is reimbursed for collecting and analyzing the data used for ongoing care. CPT code 99091 pays for a minimum of 30 mins a month on such remote patient monitoring activity.
CPT code 99091 description: collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time.
Lara Health simplifies remote patient monitoring as well as reimbursement claims for RPM. Let us show you in 15 minutes or less just how easy remote patient monitoring can be. Book a demo with one of our specialists now.