There is no denying the fact that advanced technology has potentially revolutionized the world. RPM (Remote Patient Monitoring) is a real case in point, it has its distinctive RPM CPT code facilitating remote healthcare treatment and tracking patient’s health. It is a significant extension of telehealth and robust augmentation offering numerous benefits in the health industry. It is a substantial substitute for in-person medical check-ups. It is a wonderful addition allowing healthcare providers to check and manage their patients in the comforts of their homes.
Unlock a Huge Financial Potential through RPM CPT Code
To transform the financial health of your practice, your healthcare workers must master the recent RPM CPT code to ensure higher initial reimbursement. With these codes properly used in RPM services, you can increase your financial potential and reduce claim denials. Additionally, make sure your billing codes are aligned with the services you offer to avail greater financial returns, ensuring stability and improved patient care. Remote patient treatment has been specifically designed to provide personalized care, continuous team management, and informed patient condition management.
What Are RPM CPT Codes?
RPM CPT codes are typically 5-digit numerical codes, without a decimal mark, except for a few that include one letter followed by four numbers. These codes are assigned to each task performed and service provided by a healthcare provider to patients. These codes are the transparent means to bill and track medical services, each code is different according to the particular patient’s conditions.
What Services Are RPM CPT Codes Used For?
Current Procedure Terminology codes include medical, surgical, and diagnostic services. These codes are used by insurers to determine the amount they are required to pay healthcare providers. To avoid ambiguity and ensure clarity, RPM CPT codes are the same for everyone and everywhere. Some codes are used frequently while others are seldom used. For example, the code 99214 is often used and is general.
RPM CPT Codes with Chronic Care Management
Remote patient monitoring services have been specifically designed for patients 65 years of age or older who have a chronic disease. Since healthcare services are delivered through remote interactions, either by telehealth platform or by phone, Chronic Care Management is billable when a physician spends at least 20 minutes with the patient performing appropriate tasks. Chronic Care Management supports its own CPT billing codes that can be concurrently billed with RPM, supporting dual reimbursements. Nevertheless, all-time requirements and CCM services must be separately met from RPM.
This is also the case for health clinics in the solitary areas as well as federally qualified healthcare centers. However, these groups must use HCPCS code G0511.
Benefits Of RPM CPT Code
Technology-enabled remote patient monitoring services have numerous benefits for healthcare facilities. Continuous and well-facilitated monitoring of the patients fosters their trust and enhances satisfaction. Since all RPM services are supported by the latest and the most sophisticated technology, it lightens administrative burden, streamlines the procedure, and provides more time and resources to healthcare providers to spend time producing exceptional healthcare services. It helps drive potential stability to your finances and ensure overall operational efficiency in your system. Healthcare professionals are adept at providing compliant services by using accurate RPM CPT codes to stay ahead of their competitors in the market.
Role Of RPM CPT Codes in Reimbursement Process
The Centers for Medicare and Medicaid Services (CMS) introduced five CPT codes to incentivize more healthcare professionals to use remote patient monitoring and boost their revenue cycle. Those five primary CPT codes of remote patient monitoring include:
CPT 99453
CPT 99454
CPT 99457
CPT 99458
CPT 99091
CPT Code 99453
RPM starts with medical equipment designated as a means of assistance for people not tech-savvy and familiar with navigating mobile phones, or who face difficult times with the use of medical devices. These PRM CPT codes assist them in getting specific education and training to effectively use these devices to manage any difficulty. In return, healthcare professionals get compensation for administering these services to patients. This includes the time spent on providing education or onboarding of patients and under this code the enrolment for RPM is reimbursable.
It is also important to understand that CPT Code 99453 can be billed only once. It is not reimbursable twice using the same medical healthcare workers or National Provider Identifier (NPI) number.
CPT Code 99454
CPT code 99454 starts to be applied after the whole enrolment process of a patient is complete under RPM and services begin. Its function includes alerting transmission and reporting the administration of healthcare devices for health-related data. Once it starts working, it is reimbursable under CPT Code 99454. CPT Code 99454 is valued for the supply and programming of health-related devices.
CPT Code 99457
This RPM CPT Code 99457 reimburses for the time the healthcare provider spends on remotely monitoring physiologic parameters such as blood pressure, respiratory flow rate, weight, pulse oximeter, respiratory flow, etc., initially 20 minutes per calendar month. It also covers management services and time spent by clinical staff, physicians, and other qualified healthcare professionals in interactive communication sessions with caregivers and patients during the month. RPM CPT code is reimbursable is only once in a month.
CPT Code 99458
This code reimburses healthcare providers for each additional twenty minutes they spend each month in interactive monitoring sessions with patients. This RPM CPT code can be billed twice in each calendar month.
CPT Code 99091
As per CMS policies, RPM CPT Code 99091 is still valid, the codes mentioned above effectively depict the various medical conditions of patients that require billing. This code focuses on the patient data collected in a month and cannot be billed in the same month like CPT Code 99457 and 99458.