CPT Code Reimbursement Assistance

CPT codes for remote patient monitoring

Telemedical Partners provides CPT code reimbursement assistance services.  We know CPT and HCPCS codes for telemedicine cold. Plus we have navigated the reimbursement process for years.

If you are looking for reimbursement advice for your practice, give us a call  (ext 705) or send an email.  .  Remote Physiologic Monitoring is now heavily weighted in your MIPS calculations.

CMS Code reimbursements were updated April 1, 2020. The 2021 update is out for comments at present.
Download the CMS 2020 Reimbursement Schedules below.

Director Reimbursement Mark Pearson

Mark Pearson

Hello!  Figuring out the reimbursement puzzle is challenging.  I should know, I have been doing it for 30 years!
I am Mark Pearson, Director of Reimbursement. My job is to help medical practices understand and utilize reimbursement codes properly.  Let me help you solve this puzzle.  Just send me an email to get started or call me at 800-940-1773 ext 705.

Telemedicine CPT Codes

Chronic Care Remote Physiologic Monitoring (RPM)

  • Remote Patient Monitoring is an extension of Chronic Care Management (CPT 99091.) Starting in 2020, the practice can make patient calls or have them performed by a qualified healthcare professional as part of an agency. Note: 99091 cannot be used simultaneously with remote monitoring codes 99457 – 99458.
  • Although referred to as chronic care, CMS has not restricted Remote Physiologic Monitoring to chronically ill patients.
  • RPM is upgraded in 2020 from a medium weighted Merit-Based Incentive Payment System (MIPS) activity to a heavily weighted activity making RPM even more valuable to the PCP in maintaining their Medicare reimbursements.
  • Medicare Advantage (Medicare Part C) plans (MA Plans) will now reimburse for Chronic Care RPM, Virtual Communications, E-Visits, and Interprofessional Internet Consultations.
  • RPM is now be allowed in the Home Health system under their allowable administrative costs reports.
RPM CPT Code 99453  Reimbursement: $18.77 per set up (One time payment)
Remote monitoring of physiologic parameters: 
Patient education on equipment use performed in office (at present.) Reimbursement for the practice expense associated with furnishing RPM thus no physician work is required to bill
RPM CPT Code 99454  Reimbursement $62.44  (Monthly)
Remote monitoring of physiologic parameters: 
Device supply with daily readings or programmed alerts transmission, each 30 days. Reimbursed for the practice expense associated with furnishing RPM thus no physician work is required to bill. The minimum number of days with measurements to qualify is 16 per month.
​RPM CPT Code 99457  Reimbursement:  $51.61  (Monthly)
Remote physiologic monitoring treatment management services
The first 20 minutes of clinical staff/physician/other (auxiliary staff included) qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month including reviewing patient data.
RPM CPT Code 99458  Reimbursement:  $42.22  (Monthly)
Remote physiologic monitoring treatment management services
An additional 20 minutes or more to 99457 after satisfying the first 20 minutes..

E-Visits

There are 6 new codes in 2020 for the category of “E-Visits.” This provides a reimbursement for physician practices for conducting digital health assessments and evaluations for their patients. The VitalCare platform has this capability built in.

HCPCS code G2061: ($12.27) Qualified nonphysician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5-10 minutes
HCPCS code G2062: ($21.65) Qualified nonphysician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11-20 minutes
HCPCS code G2063: ($33.92)Qualified nonphysician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes
CPT code 99421: ($15.52) Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5-10 minutes
CPT code 99422: ($31.04) Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 11-20 minutes
CPT code 99423: ($11.19) Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes

Evaluation of Patient Submitted Images/Video

HCPCS G2010 ($12.27): Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment. Billable up to 7 visits per month.

Video Patient Check-ins

HCPCS G2012 ($14.80 ): Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related E/M service provided within the previous 7 days nor leading to an E/M service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. Billable up to 7 visits per month.

Interprofessional Internet Consultations

CPT 99446 ($18.41): Interprofessional telephone/Internet assessment and management service provided by a consultative physician including a verbal and written report to the patient’s treating/requesting physician or other qualified health care professional; 5-10 minutes of medical consultative discussion and review
CPT 99447 ($37.17): Same as 99446, but 11-20 minutes of medical consultative discussion and review
CPT 99448 ($55.58): Same as 99446, but 21-30 minutes of medical consultative discussion and review
CPT 99449 ($73.98): Same as 99446, but 31 minutes or more of medical consultative discussion and review
CPT 99451 ($37.53): Interprofessional telephone/Internet/electronic health record assessment and management service provided by a consultative physician including a written report to the patient’s treating/requesting physician or other qualified health care professional, 5 or more minutes of medical consultative time
CPT 99452 ($37.53): Interprofessional telephone/Internet/electronic health record referral service(s) provided by a treating/requesting physician or qualified health care professional, 30 minutes
Click to find out about CPT codes and ICD-10 Codes for the CoVa Monitoring System

Disclaimer: The information provided on this website is current as of January 2020 and was obtained from third-party sources and is subject to change without notice as a result of changes in reimbursement laws, regulations, rules, policies, and payment amounts. All content on this website is informational only, general in nature, and does not cover all situations or all payers’ rules and policies. This content is not intended to instruct hospitals and/or physicians on how to use or bill for healthcare procedures, including new technologies outside of Medicare national guidelines. A determination of medical necessity is a prerequisite that Telemedical Partners, LLC assumes will have been made prior to assigning codes or requesting payments.

​Under Federal and State law, it is the individual provider’s responsibility to determine appropriate coding, charges and claims for a particular service. Policies regarding appropriate coding and payment levels can vary greatly from payer to payer and change over time. Telemedical Partners, LLC recommends that providers contact their own regional payers to determine appropriate coding and charge or payment levels.

Download 2020 CMS Fee Schedule