CPT CODES FOR REMOTE PATIENT MONITORING

Three new CPT codes for physiologic monitoring went into effect on January 1, 2019: 99453, which covers the set-up of devices and patient education on using the equipment; 99454, which covers the device(s) used for monitoring; and 99457, which covers the actual RPM and treatment management services.


Code 99453:

Remote monitoring of physiologic parameter(s) (e.g, weight, blood pressure, pulse oximetry, glucose monitoring), initial; set-up, and patient education on use of equipment. CPT 99453 offers reimbursement for the work associated with onboarding a new patient onto an RPM service, setting up the equipment and educating the patient on using the equipment.

Code 99454:

Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. CPT 99454 offers reimbursement for providing the patient with an RPM device for a 30-day period. Note that 99454 can be billed each 30 days.

Code 99457:

Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month. Under this new code, CMS will reimburse for clinical staff time that contributes toward monitoring and interactive communication which includes phone, text and email.

Code 99458:

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.

Code 99091:

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 healthcare professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days.


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