If you are looking for the most comprehensive CMS Remote Patient Monitoring code guide, you’ve come to the right place. The newest CMS rules simplify the process of billing and reimburse remote patient monitoring services. You no longer need to fill out dozens of forms or deal with duplicate paperwork. Instead, simply use the new codes to offset staff time and support your continued patient care. The Complete Guide to CMS Remote Patient Monitoring codes makes the process more accessible than ever.
CMS will reimburse for remote physiologic monitoring services during a public health emergency. If the services are not performed by a qualified healthcare professional or clinical staff at one healthcare facility, providers should consider CPT 99457. CMS does not specify what technologies are eligible for remote patient monitoring services. In the future, remote patient monitoring CMS will likely issue guidance to practitioners, ensuring remote patient monitoring is reimbursed efficiently.
CMS reimburses for the initial setup and education of monitoring devices. CPT 99454 covers services, including ongoing service and education. Third-party remote patient monitoring partners can help ease the logistical challenges associated with RPM.
Meaning of CPT codes
A recent CMS rule makes the Meaning of CPT codes for CMS remote patient monitors more clear. CMS has updated CPT codes to include “real-time interactive communication” in the definition of care management. Before the rule change, interactive communication was defined as the sole activity for which the physician would bill for services. However, CMS states that a reasonable proportion of such communication must occur monthly. In other words, the amount of interactive communication required in a 20-minute code is dependent on the type of patient-provider relationship.
While the CMS has updated the rule, it is still unclear which code is the most applicable to remote patient monitoring. Code 99457 covers services provided by clinical staff. It covers supplies and equipment and includes patient education and communication time. The code 99458, on the other hand, is an add-on code to 99457. It cannot be used as a stand-alone code but must be billed in conjunction with the CPT code 99457.
Meaning of 99453
The purpose of CPT code 99453 for CMS Remote Patient Monitoring is to reimburse hospitals for the cost of remotely monitoring a patient’s vital signs. The CPT code 99454 can only be used once per episode of care. Its purpose is to reimburse for the set-up of the monitoring device and patient education. In addition, the device can be used by nonclinical staff members who are not directly involved in the patient’s care but can alert clinical staff of abnormalities.
While the purpose of CPT code 99453 is to reimburse a physician’s services for remotely monitoring a patient, the actual practice of remote physiologic monitoring varies widely. For example, some devices use Bluetooth to connect to the patient’s measurement device. Others use Wi-Fi or cellular data to transmit information. This makes the reimbursement process easier for the provider, but the CPT code is not a substitute for a physician’s visit.
Meaning of 99457
The Meaning of CPT 99457 for CMS Remote Patient Monitoring pertains to time spent by physicians performing these services. For non-QHCPs, this code doesn’t apply. The rule is more explicit about what constitutes intra-service work. For example, it includes non-face-to-face care management or interactive communication.
The CPT code 99457, for instance, covers up to 20 minutes per month of remote monitoring. However, the code does not include the time spent on patient education or device setup. In addition, it must be billed in conjunction with 99453. Finally, the data must be transmitted for 16 days within 30 days. Exceptions to the 16-day rule include Covid-19 patients. The other remote patient monitoring CPT codes include 99453, 99093, and 999981.
Meaning of 99458
In implementing the new regulations for remote patient monitoring, physicians must meet specific criteria. The time spent on remote patient monitoring must be synchronous and interactive. This includes communication with patients, video, and other types of data. In addition to these requirements, the CPT code 99458 must be provided by a certified health care professional (QHCP) physician. In other words, the QHCP must spend a minimum of 20 minutes per patient per month on remote patient monitoring. However, clinical staff may not count toward the total time required.
In determining the eligibility of RPM providers, the CMS clarified its definition of RPM services. The decision expanded the definition of RPM to cover more patient visits. It also explained that an RPM service could only be billed once per patient and per provider per 30-day period. But it did not specify how much “interactive” communication must be conducted every month, even though CMS required physicians to collect data for more than 16 days of care per patient.