Reimbursement & Billing

RPM Codes

Medical Device Utilized
16-Day Wear Per 30-Day Period
Management of Chronic Condition
Clinic Follow-Up With Patient

RPM Codes

CPT Code

CPT Code Description

CMS Reimbursement National Average*1

Code

99453

Initial patient setup, enrollment, and education of use of equipment

$19.03

Code

99454

Supply of PKG device, data collection, transmission, and report/summary services to the clinician

$55.72

Code

99457

RPM services by clinical staff/MD/QHCP for the first 20 mins of interactive communication

$50.18

Code

99458

RPM services by clinical staff/MD/QHCP that exceeds first 20 mins of interactive communication with patient; up to 2x

$40.84

*The CMS amounts listed are just the Average National Medicare Reimbursement but do not reflect MAC pricing by state or commercial reimbursement.

1. www.cms.gov/medicare/physician-fee-schedule/

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