Medicare CPT Codes

Medicare CPT Codes

By providing Remote Patient Monitoring, also known as Remote Physiologic Monitoring, a practice not only provides better healthcare but also improves healthcare practice revenues. Using connected devices, physicians can monitor patients with diabetes, hypertension, COPD and more remotely and receive reimbursement through CMS’s CPT codes for Remote Patient Monitoring.

CPT Code 99453

CPT Code 99453

Initial set-up and patient education on the use of equipment

Using CMS CPT Code 99453, physicians will be reimbursed simply for starting a Remote Patient Monitoring service, also known as Remote Physiologic Monitoring. Using CPT Code 99453, CMS reimburses approximately $19 to set up connected scales, connected blood pressure cuffs, connected glucose meters and more per patient. The reimbursement also pays to train patients on how to use the connected devices to help monitor chronic illnesses, like diabetes, COPD, hypertension and even some acute illnesses like COVID-19.



Refer to the CMS website for more details
Billing
Frequency

Once at setup

$18.80

CPT Code 99454

CPT Code 99454

Device supply with daily recording and programmed alerts

Under CMS’ CPT Code 99454, physicians are reimbursed for the daily monitoring of patients using Remote Patient Monitoring, also known as Remote Physiologic Monitoring. Every day patients use the connected devices – such as scales and blood pressure cuffs for hypertension, oximeters for COPD and glucose meters for diabetes – and healthcare data transfers to care professionals, showing the physician critical changes in a patient’s illness and allowing for new treatments to start before it becomes critical.



Refer to the CMS website for more details
Billing
Frequency

Every 30 days*

$61.90

CPT Code 99457

CPT Code 99457

Clinician spends 20 minutes in a calendar month on care management services

With CMS’ CPT Code 99457, physician practices are reimbursed for doing what is at the heart of the practice – working with patients, but with CPT Code 99457, the patient interaction can be with other specific care professionals, not just the physician. This reimbursement does not require a patient visit, it is 20 minutes combined over one month to ensure the data being provided is keeping the patient healthy while receiving treatment for chronic conditions such as diabetes, COPD and hypertension.



Refer to the CMS website for more details
Billing
Frequency

Monthly

$48.29

CPT Code 99458

CPT Code 99458

The collection & interpretation of patient data by QHCP; minimum 30 min/month

While CMS CPT Code 99457 reimburse physicians for the first 20 minutes of interaction with patients, CMS CPT Code 99458 covers additional time needed to properly care for patients with Remote Patient Monitoring, also known as Remote Physiologic Monitoring. This ensures patients who are being treated with chronic illnesses and chronic conditions such as diabetes, hypertension and COPD can receive extra care by the team of care professionals working through remote patient monitoring to keep patients healthy.



Refer to the CMS website for more details
Billing
Frequency

Monthly

$77.78**

CPT Code 99091

CPT Code 99091

The collection & interpretation of patient data by QHCP; minimum 30 min/month

The first CMS CPT code used for Remote Patient Monitoring or Remote Physiologic Monitoring was CPT Code 99091 and it differs slightly from CPT Code 99457 and CPT Code 99458. In fact, physicians can not bill for CPT Code 99457/99458 in conjunction with CPT Code 99091. CPT Code 99091 is for 30 minutes of time from a qualified healthcare provider or physician, but it does not require direct patient interaction. Finally, there are a wider range of connected devices allowed under CPT Code 99091 than other codes.



Refer to the CMS website for more details
Billing
Frequency

Monthly

$53.80


*Minimum of 16 days of monitoring
**Price after being billed twice, regular price: $38.89

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