Innovative remote patient monitoring<\/a> devices are on the rise and with each passing day more and more physicians are taking advantage of the countless benefits of RPM<\/a> by bringing them into their practice. However, while RPM can be a successful, worthwhile investment for your practice, it\u2019s important to understand how the reimbursement practice works. In this post we\u2019ll answer some important frequently asked questions regarding RPM reimbursement.<\/p>\n RPM can be beneficial for both new and established patients with varying conditions. Generally, RPM is most commonly used amongst those with chronic conditions. Care for chronic conditions is a pressing and ever-growing market, as the CDC reports that approximately 60% of Americans suffer from at least one chronic condition<\/a>, while 40% have two or more.<\/p>\n RPM is covered by Medicare and most private payers. Additionally, as of 2020, Medicaid programs in 34 states also cover RPM.<\/p>\n The American Medical Association has established five major CPT codes<\/a> commonly used for RPM billing. These codes are CPT 99091, 99453, 99454, 99457, and 99458. We\u2019ve written a separate post about 2023 CPT code reimbursement rates<\/a>, but below is a chart with a summary of each CPT code\u2019s function and average rate in 2023.<\/p>\nWho is RPM for?<\/h3>\n
Who covers RPM costs?<\/h3>\n
How does RPM reimbursement work and what are CPT codes?<\/h3>\n
| Code<\/th>\n | What It Covers<\/th>\n | 2023 Rate<\/th>\n<\/tr>\n<\/thead>\n |
|---|---|---|
| 99091<\/td>\n | Collection and interpretation of remotely collected data<\/td>\n | $54<\/td>\n<\/tr>\n |
| 99453<\/td>\n | Initial set-up time, including onboarding<\/td>\n | $19<\/td>\n<\/tr>\n |
| 99454<\/td>\n | Supply and use of the remote patient monitoring devices<\/td>\n | $50<\/td>\n<\/tr>\n |
| 99457<\/td>\n | Time spent by physicians monitoring and interpreting patient data<\/td>\n | $48<\/td>\n<\/tr>\n |
| 99458<\/td>\n | Additional time spent by the physician monitoring and interpreting data<\/td>\n | $39<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\nAre there co-pays with RPM?<\/h3>\nYes, there are typically co-pays for RPM charges.<\/p>\n Is there anything else I should know about RPM reimbursement?<\/h3>\nThere are certain requirements for the different billing codes, such as how patients are required to be monitored for a 16 day minimum before billing CPT 99454, so it\u2019s important to know the specifics of each of the RPM CPT codes<\/a>. Further, in order to bill for RPM, you must confirm that your RPM devices match up to the medical device definition provided by the U.S. Food and Drug Administration<\/a>.<\/p>\n Once you get RPM set up within your practice, monitoring and subsequent is quick, easy, and accessible. Check out eDevice\u2019s trusted remote patient monitoring solutions<\/a> to bring into your practice today.<\/p>\n","protected":false},"excerpt":{"rendered":" |