Remote Patient Monitoring
Optimize your remote patient monitoring billing and collections process with QB.
Remote Patient Monitoring (RPM) utilizes digital tools to collect health data from patients in one location and securely transmit it to a provider in a different location. As the demand for RPM services continues to grow, billing for these services is undergoing significant changes to keep pace with its increasing adoption. Many healthcare providers are facing challenges related to RPM billing and reimbursement for services rendered.
QB is committed to helping healthcare providers optimize their remote patient monitoring billing and collections process, reduce the time and resources spent on revenue cycle management, and meet their financial goals. Our RPM billing solutions are efficient, cost-effective, and scalable to suit each provider’s unique and growing needs.
Remote Patient Monitoring Billing Codes
To help healthcare providers maximize revenue, the introduction of specific Current Procedural Terminology (CPT) codes for RPM services has made it easier to obtain insurance reimbursement. Using the wrong codes can lead to payment recoupments or even claim denials. It is crucial to remember that RPM services can be billed when performed by a physician, qualified healthcare professional, or clinical staff.
The following five remote patient monitoring billing codes can significantly improve a provider’s revenue:
- Service Initiation – CPT 99453
Covers the initial setup, patient education, and monitoring of physiologic parameters (e.g., blood pressure, weight, pulse oximetry). It’s reported when monitoring is done for at least 16 days. - Data Transmission – CPT 99454
Includes device supply with daily recording and transmission of data for a 30-day period, including the initial collection and transmission of data to the managing clinician. - Treatment Management Services (1) – CPT 99457
Includes 20 minutes of clinical staff/physician/qualified healthcare professional time in a calendar month, requiring interactive communication with the patient or caregiver. - Treatment Management Services (2) – CPT 99458
Adds additional 20-minute increments to CPT 99457, listed separately in addition to the primary procedure code. - Data Analysis & Interpretation – CPT 99091
Covers the collection and interpretation of physiologic data (e.g., ECG, blood pressure) transmitted by the patient to the physician, requiring a minimum of 30 minutes per 30-day period.
Frequently Asked Questions
Physicians, qualified healthcare professionals, and clinical staff can order and bill for RPM services, provided the necessary criteria are met.
Interactive communication refers to real-time, two-way communication between the healthcare provider and the patient or their caregiver to discuss treatment and management.
Time is counted in increments of 20 minutes. For CPT 99457, the first 20 minutes of interactive communication are counted, and CPT 99458 adds additional 20-minute increments.
Yes, RPM services can be billed for both new and established patients, provided the service criteria are met.
Yes, patient consent is required for RPM services to be provided and billed, and this consent must be documented appropriately in the patient’s record.
QB’s team of experts is here to ensure that your RPM billing process is seamless, compliant, and optimized to maximize reimbursement. Let us handle the complexities of RPM billing while you focus on delivering exceptional care to your patients.