Medicare Reimbursement

Remote Patient Monitoring for Monthly Recurring Revenue

Our RPM services not only provide vital health monitoring but also offer a steady stream of monthly recurring revenue for healthcare providers. This encompasses essential elements such as:

  • Device setup and training
  • Ongoing reimbursements for equipment transmissions
  • Continuous monitoring

Overview of the Process

First, the healthcare provider supplies the patient with an array of remote physiological monitoring (RPM) devices or a comprehensive device kit, including scales, blood pressure monitors, glucometers, thermometers, pulse oximeters, medication aids, and EKG monitors.

The patients then incorporate these devices into their daily routine at home, using them when necessary. As the devices collect patient data, this information is seamlessly transmitted to a secure cloud portal. This streamlined process significantly simplifies data review and facilitates efficient follow-up procedures.

Reimbursements Are Issued For:

  • Monthly recurring payments for patient monitoring, CPT 99458, 99457
  • A one-time payment (per patient) for initial equipment setup and training, CPT 99453
  • Monthly recurring payments for device transmission, CPT 99454

RPM Revenue Generator

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*CMS rates may vary from state to state

CMS CPT Billing Codes

RPM Codes

CPT 99457 - $54

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.

CPT 99458 - $42

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; additional 20 minutes.

CPT 99453 - $21

Remote monitoring of physiologic parameters (e.g., weight, blood pressure, pulse oximetry, etc) initial; setup and patient education on use of equipment.

CPT 99454 - $69

Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s)or programmed alert(s) transmission, each 30 days.

CCM & TCM Codes

HCPCS G2058 - $38

Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (limit 2x per month).

HCPCS G0506 - $64

Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to code for primary procedure).

CPT 99495 - $188

Transitional Care Management Services with the following required elements: Medical decision making of at least moderate complexity during the service period; face-to-face visit within 14 calendar days of discharge.

CPT 99496 - $248

Transitional Care Management Services with the following required elements: Communication (Direct contact, Telephone, Digital) with the patient and/or caregiver within 2 business days of discharge; Medical decision making of high complexity during the service period; face-to-face visit thin 7 calendar days of discharge.

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