What is CPT 99454

What is CPT Code 99454?

by Matt Ethington

CPT Code 99454 is one of four Remote Physiologic Monitoring codes that were introduced by CMS for Calendar Year 2019.

CPT Code 99454 reimburses providers $69 per patient per month for – “Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s)or programmed alert(s) transmission, every 30 days.”

$69 per patient per month and is paid when a practice can demonstrate that a patient has electronically submitted one or more vital statistics on at least 16 calendar days in a month

It reimburses $69 per patient per month and is paid when a practice can demonstrate that a patient has electronically submitted one or more vital statistics on at least 16 calendar days in a month.

Blood pressure to inform hypertension treatment and blood glucose to inform diabetes management are the two most utilized vitals in RPM nationwide.  Weight and heart rate round out prominent cardiac monitoring along with pulse ox for pulmonology.

Practices do not require expensive and specialty ‘connected devices’ to be able to bill for RPM, CPT 99454.  Guidelines require that the patient utilize an FDA approved device (any off the shelf blood pressure cuff or glucometer for example) and electronically submit those results.

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