Medical reimbursements are responsible for categorizing not only the billing rates and rules for procedures but also other associated services such as treatments.
If you are a medical professional, do you have an idea about the price and workflows of the most popular programs, such as remote patient monitoring (RPM)?
Getting all the information related to RPM, such as billing codes, can help you achieve a clear picture of what’s expected for both the patients and Medicare in Remote Patient Monitoring. Having a sound knowledge of billing codes can help facilities in projecting their revenue for the upcoming quarters, and make informed hiring decisions.
All you Need to Know about Remote Patient Monitoring
Remote patient monitoring solution is considered a telehealth option that is designed to assist providers and medical staff in collecting real-time data with the help of various digital devices.
Patients that are covered by Medicare Part B are eligible to enroll in this program. It is normally a monthly billable program in which at least 20 minutes of service is provided. In the RPM program, patients can take digital medical devices with them to collect readings daily. All this data is then transmitted to their doctor. Some of the readings that can be taken from these devices are stated below:
- Blood Pressure
- Glucose Level
- Heart Rate
- And much more.
All this data should be gathered with the help of a Health Insurance Portability and Accountability Act (HIPAA) compliant device.
As telehealth solution has now become one of the primary mediums to provide medical care, it is mandatory for organizations to get reimbursements accurately.
Remote Patient Monitoring CPT Codes
In the sheet below, you will find a quick and easy guide to all five primary RPM CPT codes. We will provide you with a walk-through of all the codes one by one so that there will be no confusion at all.
CPT Code 99453
CPT code 99453 deals with the time spent on the initial setup. To explain further, it covers the onboarding of a patient for RPM services by the medical staff. This code is valid just once per clinical procedure.
CPT Code 99454
CPT code 99454 deals with monthly remote monitoring of a patient. All the supply and use of medical devices come under this code, but it only includes data transmission and does not cover the time spent to educate and set up the device.
CPT Code 99457
Initial treatment management of the patient is covered by CPT code 99457. It also covers reimbursements of the initial 20 minutes of time that has been spent by the clinical staff with the patient.
CPT Code 99458
Additional treatment management of the patient is covered by CPT code 99458. It also covers reimbursements of the initial 20 minutes of time that has been spent by the clinical staff with the patient. This CPT code is used as a follow-up of 99457 and covers all the additional time of the provider in actual treatment. This treatment can also be done on remote platforms.
CPT Code 99091
For standalone collection and interpretation of remote data, use CPT code 99091. It also covers 30 minutes of RPM clinical time that is between the patient and provider per month. Moreover, at least one instance of communication is also required. Call, virtual visit, or even email exchange all comes under this umbrella.
In this article, we have discussed the relation between medical reimbursements and current procedural terminology and how they are interlinked with each other — an idea about the RPM and all the primary 5 RPM CPT codes. We have provided an overview of the description of every code and when it can be used. Using this cheat sheet, the providers will have no issues in getting timely reimbursements. CareCloud’s RPM solution is designed to assist providers in making proactive clinical decisions. From scheduling appointment visits to updating care plans, and addressing unscheduled patient calls related to the programs, you don’t have to worry about staffing challenges as we have got you covered. For more details, get in touch with our industry-leading experts.