Medicare CPT Codes

What Are CPT Codes?

Current Procedural Terminology or CPT codes are developed by the American Medical Association (AMA) to describe a wide range of health care services provided by physicians, hospitals and other health care professionals. These codes are utilized to communicate with: other physicians, hospitals, and insurers for claims processing.

By providing Remote Patient Monitoring, also known as Remote Physiologic Monitoring, a practice not only provides better healthcare but also improves healthcare practice revenues. Using connected devices, physicians can monitor patients with diabetes, hypertension, COPD and more remotely and receive reimbursement through CMS’s CPT codes for Remote Patient Monitoring.

CPT Code 99457

Device supply with daily recording and programmed alerts

Under CMS’ CPT Code 99454, physicians are reimbursed for the daily monitoring of patients using Remote Patient Monitoring, also known as Remote Physiologic Monitoring. Every day patients use the connected devices – such as scales and blood pressure cuffs for hypertension, oximeters for COPD and glucose meters for diabetes – and healthcare data transfers to care professionals, showing the physician critical changes in a patient’s illness and allowing for new treatments to start before it becomes critical.

How Much Does Medicare Reimburse?

As of 2021, the average reimbursement for CPT Code 99457 (non-facility RPM setup)

CPT Code 99458

The collection & interpretation of patient data by QHCP; minimum 30 min/month

The first CMS CPT code used for Remote Patient Monitoring or Remote Physiologic Monitoring was CPT Code 99091 and it differs slightly from CPT Code 99457 and CPT Code 99458. In fact, physicians can not bill for CPT Code 99457/99458 in conjunction with CPT Code 99091. CPT Code 99091 is for 30 minutes of time from a qualified healthcare provider or physician, but it does not require direct patient interaction. Finally, there are a wider range of connected devices allowed under CPT Code 99091 than other codes.

How Much Does Medicare Reimburse?

As of 2021, the average reimbursement for CPT Code 99458 (non-facility RPM setup)

CPT Code 99091

The collection & interpretation of patient data by QHCP; minimum 30 min/month

The first CMS CPT code used for Remote Patient Monitoring or Remote Physiologic Monitoring was CPT Code 99091 and it differs slightly from CPT Code 99457 and CPT Code 99458. In fact, physicians can not bill for CPT Code 99457/99458 in conjunction with CPT Code 99091. CPT Code 99091 is for 30 minutes of time from a qualified healthcare provider or physician, but it does not require direct patient interaction. Finally, there are a wider range of connected devices allowed under CPT Code 99091 than other codes.

How Much Does Medicare Reimburse?

As of 2021, the average reimbursement for CPT Code 99091 (non-facility RPM setup)