Reimbursement rate according to CMS Medicare physician fee schedule
CPT code 99453
CPT code 99453 covers activities associated with the initial on boarding of a patient into the RPM program.
CPT Code 99453: $18.48
CPT Code 99454
CPT code 99454 includes all the activities in supplying and daily use of the RPM device.
CPT Code 99454: $55.77
CPT Code 99457
It is billed once each month and covers activities such as monitoring and interpreting patients' physiological data. It is a requirement that RPM services are rendered for at least 20 minutes in a 30-day timeframe. Qualified physicians or clinical staff are mandated by CMS to perform those services. It is also mandatory that one live session is logged with the patient.
CPT Code 99457: $50.18
CPT Code 99458
This is an additional 20-minute function performed in concurrence with CPT Code 99457. It can only be initiated once CPT Code 99457 has been covered. It follows similar billing requirements to CPT Code 99457.
CPT Code 99458: $40.84
CPT Code 99091
This RPM code can be billed only once for a 30-day service period and a minimum of 30 minutes are required to be spent on data evaluation and analysis of patient data. The physician or qualified healthcare professional is the only one allowed to bill this code.
CPT Code 99091: $56.41