RPM Services

6/19/20252 min read

Remote Patient Monitoring (RPM) is a healthcare practice that uses digital technologies to collect medical and health data from patients in one location and electronically transmit that information securely to healthcare providers in another location. This allows providers to monitor patients outside of traditional clinical settings, improving access to care and outcomes for individuals with chronic conditions or those recovering from acute illnesses.

RPM is commonly used for monitoring conditions such as:

  • Hypertension

  • Diabetes

  • Chronic obstructive pulmonary disease (COPD)

  • Congestive heart failure (CHF)

  • Post-surgical recovery

  • Other chronic diseases requiring ongoing tracking

How to Code and Bill for RPM

RPM is billed under CPT codes, which are categorized into device setup, data collection, and clinical interaction.

  • Initial Setup & Patient Education

  • CPT 99453 covers the initial setup of the RPM device, patient education on its use, and onboarding.

  • Requirements: The device must be capable of transmitting data electronically.

  • Reimbursement: One-time billable per patient per episode of care.

  • Device Supply & Data Transmission

  • CPT 99454 covers the supply of the device and ongoing transmission of physiologic data.

  • Requirements: Data must be collected and transmitted for at least 16 days in a 30-day period.

  • Reimbursement: Billable once per 30-day period, not per device.

  • Data Review & Clinical Monitoring

  • CPT 99457 covers the first 20 minutes per month of monitoring and management by a qualified healthcare professional.

  • Requirements: Includes live interaction with the patient, analysis of data, and care coordination.

  • Reimbursement: Monthly, requires at least 20 minutes of clinician time.

  • CPT 99458 covers an additional 20 minutes of monitoring per month.

  • Requirements: Billed alongside 99457 when time exceeds 20 minutes.

  • Reimbursement: Can be billed multiple times depending on time spent.

RPM Billing Requirements & Compliance

To bill for RPM services, providers must:

  • Use FDA-approved or equivalent medical devices for data collection.

  • Obtain patient consent (written or verbal).

  • Ensure at least 16 days of transmitted data per 30-day period for CPT 99454.

  • Have direct provider or clinical staff involvement for CPT 99457 and 99458.

  • Document all services to support claims and audits.

A proper workflow is key to ensuring your office is billing RPM services correctly. If you need assistance, please contact us at www.triumphmps.net or call 214-305-8805 so our experienced consultants can help.