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CPT Codes for Remote Patient Monitoring (RPM)

The Centers for Medicare and Medicaid Services (CMS) has provided its rules regarding the reimbursement for remote patient monitoring (RPM) services.

The changes that are currently in place for 2020 will allow healthcare providers to accelerate their adoption of RPM and its impact to the improvement of their patients' health. The addition of these CPT codes allows for a greater flexibility for providers that opt to utilize RPM services for the patients they serve.

CPT codes for providing RPM services to patients, as well as staff time spent monitoring these patients:

CPT Code 99453 = $21 (one time)
Patient onboarding, once per episode of care

CPT Code 99454 = $69
Supply of medical devices. Patient Generated Health Data (PGHD) collection, transmission and summary of services (16 days of PHGD)

CPT Code 99457 = $54
Initial 20 minutes of remote physiologic monitoring by Clinical Staff

CPT Code 99458 = $43
Each additional 20 minutes of remote physiologic monitoring by clinical staff. Max 60 minutes/month

Reimbursement example using RPM CPT codes:

For 20 minutes review = $144
CPT Code 99453 = $21
CPT Code 99454 = $69
CPT Code 99457 = $54

For 40 minutes review = $187
CPT Code 99453 = $21
CPT Code 99454 = $69
CPT Code 99457 = $54
CPT Code 99458 = $43

For 60 minutes review = $230
CPT Code 99453 = $21
CPT Code 99454 = $69
CPT Code 99457 = $54
CPT Code 99458 = $43
CPT Code 99458 = $43

*All the calculations are per patient per month (pppm)

CPT Codes for Chronic Care Management (CCM)

The following CPT codes can be used for patients with two or more chronic medical conditions expected to persist more than 12 months following diagnosis and that place the patient at an increase risk for hospitalization:

CPT Code 99487 = $54
Initial 60 minutes non face-to-face consultation establishing or monitoring a care plan

CPT Code 99489 = $92
Each additional 30 minutes non face-to-face consultation (with 99487)

CPT Code 99480 = $47
Minimum 20 minute non face-to-face consultation monitoring the care plan

CPT Codes for Remote Patient Monitoring (RPM)

CPT codes for providing RPM services to patients, as well as staff time spent monitoring these patients:

Reimbursement example using RPM CPT codes:

CPT Codes for Chronic Care Management (CCM)

The following CPT codes can be used for patients with two or more chronic medical conditions expected to persist more than 12 months following diagnosis and that place the patient at an increase risk for hospitalization:

Reimbursement example using a combination of RPM and CCM program:

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CPT Codes for Remote Patient Monitoring (RPM)

CPT codes for providing RPM services to patients, as well as staff time spent monitoring these patients:

Reimbursement example using RPM CPT codes:

CPT Codes for Chronic Care Management (CCM)

The following CPT codes can be used for patients with two or more chronic medical conditions expected to persist more than 12 months following diagnosis and that place the patient at an increase risk for hospitalization:

Reimbursement example using a combination of RPM and CCM program:

Dedicated Support at Every Step!

Our Experts are available 24 hours a day, 7 days a week to help you!

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