Benchmark Systems

An Overview of RPM CPT Codes

January 26, 2023

Remote patient monitoring, or RPM, is one of the most rapidly evolving subsets of healthcare services. Over the years, technological advances have made it easier for patients to track valuable data points at home – and now, that data can be securely uploaded directly to a patient’s care team. With an RPM program in place, practices can provide more effective patient care through efficient, forward-thinking service delivery. 

However, to receive these touted benefits, these services must be properly charged with the correct RPM CPT Codes. Below, we will define RPM CPT codes, explore some of the most common codes, and explain why they are highly reimbursable.

What Are RPM CPT Codes?

To capture revenue and be reimbursed for RPM, medical billing staff must utilize the appropriate CPT codes. The RPM CPT billing codes and a brief description of each are listed below:

  • CPT 99453: Remote monitoring of physiological parameters, initial, which includes patient education and setup of equipment. Parameter examples are weight, pulse oximetry, etc.
  • CPT 99454: Remote monitoring of physiological parameters, initial, which includes the supply of daily recordings or programmed alerts transmission and occurs every 30 days. Parameter examples are weight or respiratory flow rate.
  • CPT 99457: Remote physiological monitoring treatment services that take 20 minutes or more of the staff’s professional time in a month and require interactive communication with the caregiver and patient throughout the month.
  • CPT 99458: Remote physiological monitoring treatment services. This CPT Code is similar to CPT 99457. However, it is an additional 20 minutes following CPT 99457’s initial 20 minutes.
  • CPT 99091: Collection and interpretation of physiological parameter data such as blood pressure and glucose monitoring. The information collected is transmitted and stored digitally and requires a minimum of 30 minutes of a physician’s time.

Staff and practitioners use the RPM CPT codes described above to capture an accurate picture of the services received and the information needed for the practice to be properly reimbursed. The most popular RPM CPT codes are CPT 99453, CPT 99454, CPT 99457, and CPT 99458 because they capture in totality the elements of telehealth care that can be performed with RPM services.

RPM Is Highly Reimbursable when You Use the Right CPT Codes.

RPM is highly reimbursable, and that’s just one of many key benefits to implementing a remote patient monitoring program. When used correctly, RPM CPT codes allow practitioners and staff to accurately depict the services they disseminate to payers. On average, reimbursement for one RPM encounter is $120. Reimbursements for a practice with at least 50 patients can net $72,000 in revenue annually. As a result of the COVID-19 pandemic, many practitioners have started providing more telehealth services — including RPM — and this trend has proven to be quite lucrative.

Our Experts Can Help You Launch A Profitable RPM Program.

Our team of experts can help you identify what features and tech you need to establish a profitable RPM solution. With in-house billing experts and superior interoperability capabilities, Benchmark Systems can provide your practice with an all-in-one system tailored to your needs. 

If you are interested in the Benchmark Remote Patient Monitoring solution, contact us today.
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