CMS Codes Explained for Your Practice – Part Five
CPT CODE 99457 and 99458: Treating Chronic Conditions with RPM
At the heart of any practice is treating patients. Likewise, the entire purpose of Remote Patient Monitoring, or Remote Physiologic Monitoring, is treating your patients better through the use of technology.
By using Remote Patient Monitoring, you’re staying connected with your patients more and keeping your patients healthier – addressing issues before they become critical.
But, it’s not just the connected devices – such as smart scales, blood pressure cuffs, oximeters and glucose meters – that do the work. It still requires a qualified healthcare professional to interact with the patient and analyze the data from the connected devices for chronic care.
Specifically, CPT 99457 covers “Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/ physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month. (Interpretation of the received data and interaction with patient on a treatment plan by a clinician)”
And CPT Code 99458 covers “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.”
Basically, this provides reimbursement for your interactions, approximately $48 for CPT 99457 for the first 20 minutes of care during a month and approximately $38 for CPT 99458 for each additional 20 minutes of care. Plus, you can bill for CPT 99458 twice a month if you provide an hour of care.
A couple of points to make to fully understand what this means. This does include any communication with patients, such as an email, a text or a consultation. This also includes any interpretation of data provided by a connected device.
Centers for Medicare and Medicaid Services was also clear that it does not have to be a physician providing these services, but it must be with a Qualified Healthcare Professional under the supervision of the physician.
This is what allows Medek RPM to make your practice successful with Remote Patient Monitoring. We have a team of care professionals specifically trained on how to interpret the data for all of the chronic care conditions covered by RPM.
From diabetes to hypertension to COPD and much more, our care professionals are there to ensure your patients are cared for and that the physician is alerted when there are any issues with patients that may become critical.
Of course, all the data is open and accessible for any physician to interpret easily and quickly through our custom software.
One key element of both CPT Code 99457 and CPT Code 99458 is the amount of meticulous record keeping required for reimbursement by Medicare, Medicaid and most private insurances. Imagine tracking every interaction with your patients and tracking every minute reading data.
You don’t have to imagine it because that is what Medek RPM offers – a full slate of reimbursement services to ensure you receive the full amount available with no issues.