Ann: RPM CPT Reimbursement & response to statements made by ADR, page-11

Hi all,

I've found the link that @lucasq originally shared with me back in March 2021. This link explains how CMS issued three new codes (99453, 99454 and 99457) to effectively replace/expand upon 99091:

https://insights.samsung.com/2020/09/02/the-new-rules-for-remote-patient-monitoring-reimbursement-2/

Here's another helpful summary:

CPT codes for the provision of RPM include:

• CPT Code 99453: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), plus initial set-up and patient education on use of equipment. (Initial set-up and patient education of monitoring equipment included; do not report 99453 for monitoring of less than 16 days.)
• CPT Code 99454: Device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days. (Initial collection, transmission, and report/summary services to the clinician managing the patient.)
• CPT Code 99457: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified healthcare professional time in a calendar month, requiring interactive communication with the patient/caregiver during the month; first 20 minutes.CPT Code 99458: Each additional 20 minutes (List separately in addition to code for primary procedure.)
• CPT Code 99091: Collection and interpretation of physiologicdata (e.g., ECG, blood pressure, glucose monitoring), digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, qualified by education, training, licensure/ regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days.

Source: https://www.icd10monitor.com/cms-guidance-for-remote-patient-monitoring-rpm

I think this should clear up the question raised earlier about "eligibility".

Cheers