Reimbursement Calculator and CPT Codes for Remote Patient Monitoring
With Medicare reimbursement that pays for patient education, supply, and deployment of device and treatment management services, the cost of Remote Patient Monitoring is never an issue.
Our support team will work with you to identify patients who are eligible for the service and do an eligibility verification of the patient’s insurance to confirm that the services will get paid.
Now that Medicare and other insurances reimburse for the service, it is the best time to introduce it in your practice.
Add more than 100K* Revenue per Annum with just 100 Patients
CMS started reimbursing for Remote Patient Monitoring CPT codes 99453, 99454, 99457 and 99458 codes in 2019
Remote Patient Monitoring CPT Codes
AMA introduced the following Remote Patient Monitoring CPT 99453, 99454, 99457, and 99458 Codes in 2018 to encourage the election of Remote Patient Monitoring Services. And CMS decided to reimburse them in the 2019 Medicare Physician Fee Schedule.
CMS pays for the following Remote Patient Monitoring Services:
- CPT 99453 – Education and Setup
- CPT 99454 – Device Supply
- CP 99457 and 99458 – Time Spent in monitoring the patient
CPT code 99453
(Patient Education and Setup): $19.00*
Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; setup, and patient education on the use of equipment.
CPT 99453 is incorporated with the patient onboarding service on educating on how to use the monitoring devices. The patient must give consent to Remote patient Monitoring Services. This is only billed once with a minimum billing of 16 days.
CPT code 99454
(RPM Device Supply): $65.00*
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, every 30 days.
CPT 99454 is associated with suppling the Remote Patient Monitoring Device. The device must transmit the readings electronically. This is a recurring incentive paid every 30 days.
CPT code 99457
(Initial 20 Minutes of Patient Monitoring): $52.00*
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.
CPT code 99458
(Every 20 additional Minutes of Patient Monitoring): $42.00*
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
Every 20 additional minutes spent by the healthcare professional in monitoring the patient health in examinations or Follow-ups. This can also be served by the clinical staff under general guidance.
*National Average Medicare 2022. Confirm with your billing department/local MAC for reimbursement and requirements
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