New 2019 CPT codes 99453, 99454 and 99457 for remote patient care

New 2019 CPT codes 99453, 99454 and 99457 for remote patient care

With the boom of healthcare related technologies in doctor’s clinics and the mass adoption of smartphones by patients and health consumers, clinics and care teams are more open than ever to swap in-person appointments and routine visits with the convenience of virtual care. Especially since 2015, non-face-to-face patient care performed by clinical staff is reimbursable using CPT codes, including remote patient monitoring (RPM) services.

Which CPT codes reimburse remote patient monitoring?

The first code paying $43 for patient care outside the doctor’s office, including remote patient care, was CPT code 99490 requiring a minimum of 20 minutes each month spent by clinical staff. In January 2018, the CMS introduced the first remote patient care dedicated code by unbundling CPT code 99091 that pays $57 a month. Code 99091 requires at least 30 minutes of a physician’s time and can be billed concurrently with the CPT code 99490, so practitioners spending more than 50 minutes on CCM where at least 30 minutes includes monitoring of patient’s physiological data can earn $100 a month per qualifying patient.

What are the new CPT codes for remote patient monitoring in 2019?

In January 2019 three more codes were launched for doctors and clinics operating remote patient care: CPT 99453, CPT 99454, CPT 99457. These codes make implementing remote patient care even more attractive by now reimbursing for less time spent by clinical staff, for supplying patients with health monitoring devices and for setting these devices up for the patient use.

What patient remote monitoring CPT codes cover?

With the introduction of additional CPT codes purely dedicated to RPM as well as RPM services being covered by the CCM code 99490, doctors and clinical staff can be reimbursed for the growing number of tasks, such as reviewing of physiological data patients report electronically, providing patients with monitoring devices or educating patients on the use of such devices. Below find the 2019 CPT codes which are available to qualifying practitioners billing for RPM as part of their CCM program:

CPT 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. $21 per patient.

CPT 99454: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days, $69 per patient.

CPT 99457: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month. $54 per patient per calendar month.

A provider can bill both CPT 99457 and CPT 99490 in the same month because CMS recognizes the analysis involved in furnishing remote patient monitoring services is complementary to CCM and other care management services.

Why not maximise revenues with remote monitoring in your clinic today? A remote monitoring solution can bring extra resource to deliver in-house CCM more efficiently. By offering the best platform for both your patients and your staff, you can achieve better patient outcomes and increase practice revenue.

The QardioMD remote monitoring solution equips each patient with connected self-monitoring devices such as Bluetooth blood pressure monitors, glucometers, ECG monitors and weighing scales, so they can better engage in their own health for longer. This allows for easy continuous home-based monitoring, therefore reducing the amount of patient clinic visits.

Ready to earn reimbursement for remote patient monitoring services? Qardio’s RPM platform, QardioMD, has a built-in billing feature, which automatically tracks the time physicians spend on each patient, to improve efficiency and to reduce unnecessary audit errors. Book a demo to see how QardioMD works »