Tech & Innovation in Healthcare

Reader Questions:

Find out if More RPM Codes Are on the Way

Question: Healthcare providers in our practice enjoy using remote patient monitoring (RPM) to keep track of patients’ conditions while the patients are at home. We understand there aren’t many CPT® codes related to RPM reimbursement, but could more be added to the code set in the future?

Connecticut Subscriber

Answer: RPM is a great way to receive insight into your patients’ conditions while they live their lives. Currently, the CPT® code set features only four RPM service billable codes:

  • 99453 (Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment)
  • 99454 (… device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days)
  • 99457 (Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; first 20 minutes)
  • 99458 (… each additional 20 minutes (List separately in addition to code for primary procedure))

Codes 99453 and 99454 cover the enrollment and monthly monitoring and evaluation of data, respectively, while 99457 and 99458 are time-based codes that clinical staff use to report providing care management services, assessing the data, and reviewing the treatment plan.

However, changes could be in store for next year’s CPT® code set. This month at the May 2024 AMA CPT® Editorial Panel Meeting, several code additions and revisions are listed on the proposed agenda. The proposed agenda includes six potential new codes and nine potential code revisions.

Highlights of the RPM code changes include:

  • “Revise the Digitally Stored Data Services/Remote Physiologic Monitoring guidelines;
  • [Add] remote treatment monitoring device supply codes … to report respiratory, musculoskeletal and cognitive behavioral therapy for 2-15 calendar days;
  • [Revise] 98980 to include 11-20 minutes of service;
  • [And] revise the time component for code 98981.”

The results of the meeting will be published on or before June 7, 2024, according to the AMA.

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