A Quick Guide To Remote Patient Monitoring Reimbursement

What is Remote Patient Monitoring?

Remote Patient Monitoring (RPM) is the collection of health data by the patient, often from outside conventional care settings, which is then electronically and securely transmitted to the provider for use in care and related support. Remote Patient Monitoring can:

  • Improve the patient experience
  • Empower the patient to better manage their own health and participate in their treatment plan 
  • Increase visibility into patient adherence to treatment and enable timely intervention 
  • Strengthen the relationship between the patient and the provider
  • Help grow revenue for your organization

Determining coverage levels

Determining if there is coverage and payment for remote patient monitoring services and technologies that you plan to incorporate into your clinical practice requires research and a plan. This Quick Guide is designed to highlight key services covered and paid by Medicare on the Physician Fee Schedule in the US beginning January 1, 2019. Please note that commercial health insurers and government health care programs may have very different coverage policies and different payment amounts.

Overview of services and codes

  • Chronic care remote physiologic monitoring: CPT codes 99453, 99091, 99454, 99457 & 99458
  • Brief communication technology-based service: HCPCS code G2012
  • Remote evaluation of pre-recorded patient information: HCPCS code G2010
  • Inter-professional internet consultations: CPT codes 99451, 99452, 99446, 99447, 99448 & 99449

Remote Patient Management codes

CPT Code: 99453

Initial setup fee. Includes education on use of equipment and medical devices. Rate: $19.19 (one time)

CPT Code: 99454

Data transmission fee. Includes remote monitoring of physiologic parameters. Rate: $63.16 (billed monthly)

CPT Code: 99091

Collection & interpretation fee. Includes data digitally transmitted by the patient or caregiver for HCP review. Rate: $56.88 (billed monthly)

CPT Code: 99457

Treatment management fee. Includes interactive communication between the patient or caregiver and the clinical staff. Rate: $50.94 (billed monthly)

CPT Code: 99458

Treatment management fee. Includes interactive communication between the patient/caregiver and the clinical staff. Rate: $41.17 (billed monthly)

Want to learn more?

Our team is here to help. To learn more about relevant reimbursement codes for the Vitals Patch in your jurisdiction contact us directly.

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