Real Time Monitoring

Q: How Does CPT 99457 Compare with CPT 99458?

CPT 99458 will be used in conjunction with CPT 99457. This code (99458) represents an add on of each additional 20 minutes of RPM treatment management services.

Q: Can RPM (CPT 99457/99458) be Billed "Incident to" ? What Supervision Level is Required?

Yes, these codes may be furnished by auxiliary personnel, "incident to" the billing practitioner's professional services. An "incident to" service is one that is performed under the supervision of a physician (broadly defined), and billed to Medicare in the name of the physician, subject to certain requirements. As of January 1, 2020, Medicare is allowing general supervision - i.e.

Q: What Type of Technology Qualifies under the New RPM Codes?

Many advocates asked CMS to clarify the kinds of technology covered under CPT codes 99453, 99454, 99457, and 99458. Some groups gave examples of the kinds of technology they believe these codes should cover, such as software applications that could be integrated into a beneficiary’s smartphone, Holter-Monitors, Fitbits, or artificial intelligence messaging.

Q: Will Medicare Pay for Setting Up the RPM Device and Patient Education?

Yes. CPT 99453 offers separate reimbursement for the initial work associated with onboarding a new patient, setting up the device and patient education on the use of the equipment.

Q: Must the Patient Give Consent for RPM Services?

Yes. The patient must agree to the service and sign a consent form.