Remote Patient Monitoring (RPM) Billing – CPT Codes 99453, 99454, 99457, and 99458 – Help Your Healthcare Organization Increase Revenue

Remote Patient Monitoring is becoming a more common practice among Medicare patients who want to keep costs down while still receiving the necessary care they need. RPM billing can be beneficial for patients who are unable to come into the office or clinic due to transportation issues. It is important for providers to review the patient’s records and call if there are any changes such as an escalation in symptoms.

RPM software service that allows providers to keep track of all the patients with their assigned identification numbers. When you have a large number of patients, it is difficult to keep track of those who are compliant with the treatment plan and those who are not. This dashboard data helps make sure that those who are not compliant get noticed, so they can be brought back into compliance.

This has created a new billing code, which is a set of codes used to identify various medical services and procedures offered to medicare beneficiaries.

CPT Code Billable Event/ Time 
99453Initial (Device) Set-Up
99454Data Transmission (Daily Collected Data)
9945720 mins 
99458Additional 20 mins

CPT Billing Code

Remote Patient Monitoring Enrollment 

The first step in healthcare is enrolling the patient. Ensuring that the patient has a routine physical exam, laboratory tests, and other preventative care can help decrease the likelihood of chronic illnesses and illness-related death.

Consent is a process that allows both the patient and the provider to make a decision about whether or not they want healthcare services. In order to provide safe and effective care, providers should ask patients for consent before providing them with healthcare services which includes asking permission to take their blood pressure, take their temperature

Providers should also inform patients of what the risks are when providing these types of services. Written consent is important to ensure that the patient is not accidentally enrolled. We recommend that written consent be filled out when it is practical and possible. This will allow patients to keep a record of their enrollment if needed.

Consent is a legal document that includes the patient’s understanding of what will happen during treatment. It is important for the patient to understand exactly what they are giving consent for so that there is no confusion about what type of treatment they are agreeing to.

Track Your Device Using RPM Software 

The device to be given to the patient has to be linked to the RPM software and the patient must be educated on it. The patient must understand how it works, what it does, and why is important for them.

The conditions to track must be marked and the condition and device that are being tracked. For example, an RPM tracking device that is linked to an oxygen tank can track when it is empty, or whenever the oxygen level drops below a certain point. This allows for continuous usage of the device.

Medicare insurance is not only meant for the elderly and disabled, but also for people under 65 who are unable to work or have a chronic condition. Medicare insurance is often associated with high deductibles, high copays, and limited benefits. However, medical billing services can help you get the most out of your Medicare coverage by lowering deductibles and making copays more affordable.

Medicare RPM Billing Code for Data Transmission

RPM Data transmission is the process of data being transmitted from a patient to their clinician. This allows improved and more timely diagnosis, treatment, and follow-up care during medical appointments. The code comes into use in many cases where patient care requires 24/7 monitoring and care.

Data Transmission is an additional code that was added to the Part B billing code list. The beneficiary must indicate the type of remote monitoring they have done and the codes to identify the particular features. 

The CMS defines the period of data transmission to be 16 days in a month. The period begins on the first day of the month and ends on the last day of that month. Data is transmitted daily and multiple times, but the standard amount of time that it is permitted to be in use is 16 days.

It is important to get at least one measurement a day from your patient. This will provide you with the necessary data to determine their progress. It also helps prevent any setbacks which could be detrimental to their health.

To minimize transmission errors, the aTouchAway platform from mTelehealth service uses a combination of methods to ensure that the data is received in the order it was sent and not altered in transit. These include cellular encryption, digital certificates, and cryptographic hashes.

Medicare Billing Code for RPM Review and Management 

A new billing code that will allow health care providers to charge Medicare patients who are remote users or have an outpatient service authorization. This billing code addresses the lack of telehealth funding and the need for providers to be able to bill directly through Medicare.

Automated Critical Alerts – Alerts to the appropriate clinical staff if the patient measurement goes outside range. This way all patient escalations are managed and there is no medico-legal issue. 

Smart-Review of Data – Significant amount of data comes in. Instead of manually reviewing the data, an automated smart review that showcases how the data is organized in charts and descriptions will help.

Point and click review – additional information can be added through point and click. It is important that this information is created by a competent medical professional. Many software is created by technical engineers and doesn’t consider medical items. 

With these features, a practice can focus their time on talking with the patient and building relationships with the patient instead of typing in data.