| Action | Patient receives initial setup of monitoring device and education on its use | Remote physiologic monitoring treatment management services (First 20 minutes) | Remote physiologic monitoring treatment management services (Each additional 20 minutes) | Collection and interpretation of physiologic data digitally stored and/or transmitted by the patient to physician/QHP (Minimum of 30 minutes) |
|---|---|---|---|---|
| Who is performing? | Physician/QHP/Clinical Staff | Physician/QHP | Physician/QHP | Physician/QHP |
| Applicable CPT Code(s) | 99453 - Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment | 99457 - 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; first 20 minutes. | 99458 - 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; each additional 20 minutes (List separately in addition to code for primary procedure) | 99091 - Collection and interpretation of physiologic data (eg, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/ regulation (when applicable) requiring a minimum of 30 minutes of time, each 30 days |
| Place of Service | 11 - Physician Office or other applicable site of the practitioner’s normal office location | 11 - Physician Office or other applicable site of the practitioner’s normal office location | 11 - Physician Office or other applicable site of the practitioner’s normal office location | 11 -Physician Office or other applicable site of the practitioner’s normal office location |
| Notes | (Do not report 99453 for monitoring of less than 16 days) | (Report once per calendar month, regardless of number of parameters monitored) | (Use 99458 in conjunction with 99457) | Report once per 30 days (Do not report in conjunction with 99457 or 99458) |
| Per the 4/30 IFR, CMS will allow remote physiologic monitoring services to be reported to Medicare for periods of time that are fewer than 16 days, but no less than 2 days, during the PHE. For monitoring of less than 16 days, but more than 2 days, payment for CPT codes 99453, 99454, 99091 , 99457 and 99458 is limited to patients who have a suspected or confirmed diagnosis of COVID-19. | ||||
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