Medicare

Remote Patient Monitoring for Dependable, Recurring Revenue

Covered RPM procedures include: setup and training for monitoring devices. Providers can also expect monthly recurring reimbursements for equipment transmissions and monitoring.

How Does This Process Work?

  • The patient will receive a remote physiological monitoring (RPM) device from the provider.

  • As the RPM device generates patient data, the information will automatically be uploaded electronically to the portal. This greatly simplifies the data review and follow-up process.

  • CMS issues reimbursements for:

    • A one-time payment (per patient) for initial equipment setup and training
    • Monthly recurring payments for device transmission
    • Monthly recurring payments for patient monitoring

CMS Issues Reimbursements for:

  • A one-time payment (per patient) for initial equipment
    setup and training

  • Monthly recurring payments for device transmission

  • Monthly recurring payments for patient monitoring

RPM Revenue Generator

2019 Remote Patient Monitoring CPT Codes

RPM/ONE-TIME
CPT Code 99453
Patient Set-up and Education
$21
Remote monitoring of physiologic parameters: initial set-up and patient education on use of equipment

RPM/MONTHLY
CPT Code 99454
Device and Data Transmission
$69
Remote monitoring of physiologic parameters: initial device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days

RPM/MONTHLY
CPT Code 99457
Data Interpretation
$54
Remote physiologic monitoring treatment management services, 20+ minutes per calendar month of clinical staff with the patient/caregiver

Additional Established Reimbursement Codes

CCM/MONTHLY
CPT Code 99490
Chronic Condition Care
$42
Clinical staff time of 20+ minutes for patients with two or more chronic conditions

CCM/MONTHLY
CPT Code 99487
Chronic Condition Care
$93
Complex CCM services for high-need patients for the first 60 minutes of treatment

CCM/MONTHLY
CPT Code 99489
Chronic Condition Care
$47
Supplemental code to 99487: each additional 30 minutes of complex CCM services per calendar month

CCM/MONTHLY
HCPCS Code G0506
Assessment and Planning
$64
Initial assessment of chronic condition and development of care plan

CCM/ONE-TIME
CPT Code 99495
TCM Services
$166
Modern medical decision complexity TCM services involving 30 days of remote services and an office visit within 14 days post-discharge

CCM/ONE-TIME
CPT Code 99496
TCM Services
$235
High medical decision complexity TCM services involving 30 days of remote services and an offline visit within 7 days post-discharge

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