In 2019, the CMS launched several new CPT codes dedicated to remote patient monitoring, making contactless patient care financially attractive and profitable. But how much revenue can a medical practice add by offering remote patient care? Which CPT codes pay the most and which providers are eligible for reimbursements? This article summarizes the current legislation for remote patient care and highlights the main codes to know about.

Since 2019, care providers have had the opportunity to add significant revenue by offering remote patient monitoring programs to their patients. Those with chronic conditions such as hypertension, diabetes and COPD are the most suitable patients to enroll in remote patient monitoring programs, due to the ongoing nature of their health problems and the need to stabilize and manage it long term. These are also the patients who are often advised to monitor their health at home, so enrolling them in remote patient monitoring and giving their care teams an access to their measurements means their care providers can get paid for a health routine their patients are already used to.

How much can a medical practice add a year in revenue with RPM?

Revenue generated with remote patient monitoring programs can be substantial but vary significantly across medical practices. How much your practice can earn very much depends on the type of patient mix you have, the payers you contract with and the resources you have available to run the program. 

SEE HOW MUCH YOU CAN ADD TO YOUR REVENUE WITH LARA HEALTH ON MONTHLY AND ANNUAL BASIS. USE OUR REVENUE CALCULATOR HERE.

What CPT codes are best for remote patient monitoring?

There are 4 CPT codes for remote patient monitoring that are used frequently: CPT 99453, 99454, 99457 and 99458. These CPT codes are billed per eligible patient and per instance, meaning remote patient monitoring can bring a continuous stream of monthly payments.

CPT 99453 reimburses for assistance with setting up the patient’s health tracking device and educating the patient on its use. It pays a one time flat fee of $21*.

CPT 99454 reimburses for physiological data analysis: it pays towards patients who actively participate in the remote patient monitoring and track their health by using devices equipped to share the measurements with their care providers. It pays $69* and can be billed every 30 days.

CPT 99457 reimburses for the first 20 minutes of remote patient care the care team provided in that month. It pays $54*.

CPT 99458 is an add-on code to 99458 and it pays for additional 20 minute increments of remote pare provided in the same month. It pays $43*.

So billing these 4 CPT codes would bring the medical practice $187* for each patient who qualified that month.

SEE HOW MUCH YOU CAN ADD TO YOUR REVENUE WITH LARA HEALTH ON MONTHLY AND ANNUAL BASIS. USE OUR REVENUE CALCULATOR HERE.

When choosing a RPM provider, it is important to know if their solution qualifies for RPM reimbursement and to what extent and how much admin work is required to run their program. Lara Health has built a deep expertise in remote patient monitoring and we streamline the routine work and billing so you can earn more and faster. Book a demo to see why it is so easy to care for your patients with Lara Health.

* National average amounts, individual reimbursements vary by state.