Medicare CPT Codes

By providing Remote Patient Monitoring, also known as Remote Physiologic Monitoring, a practice offers better healthcare and improves healthcare practice revenues. Using connected devices, physicians can monitor patients with diabetes, hypertension, COPD, and other chronic diseases 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 returns approximately $19 to set up connected scales, blood pressure cuffs, 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 diseases like COVID-19.




Billing
Frequency

Once at setup

$19.16

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 their 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*

$55.84

CPT Code 99457

CPT Code 99457

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

With CMS’ CPT Code 99457, physicians are reimbursed for doing what is at the heart of the practice – working with patients. This reimbursement does not require a patient visit. It is 20 minutes combined over one month to ensure the data being provided keeps 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

$50.77

CPT Code 99458

CPT Code 99458

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

While CMS CPT Code 99457 reimburses physicians for the first 20 minutes of interaction with patients, CMS CPT Code 99458 covers the additional time needed to properly care for patients with Remote Patient Monitoring, also known as Remote Physiologic Monitoring. This ensures patients 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

$82.84**


* Minimum of 16 days of monitoring
** Individual block is $41.42

Did you know?

Medek RPM’s Full-Service Remote Patient Monitoring program not only supplies you with everything you need to have a successful program, but we can also do the billing for you.

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