Connected Care Billing Codes

REMOTE PATIENT MONITORING

CPT 99457 – $54 (new 2019)
Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.

CPT 99453 – $21 (new 2019)
Remote monitoring of physiologic parameters (e.g., weight, blood pressure, pulse oximetry, etc) initial; setup and patient education on use of equipment.

CPT 99454 – $69 (new 2019)
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, each 30 days.

CPT 99091 – $59 (superseded by new 2019 RPM codes)
Collection and interpretation of physiologic data (e.g., 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.

COMMUNICATION TECHNOLOGY-BASED SERVICES

HCPCS G2012 – $10 (new 2019)
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 (E/M) 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)

HCPCS Code G2010 – $13 (new 2019)
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)

CHRONIC CARE MANAGEMENT

CPT 99490 – $42
Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:

  • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  • Chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline
  • Comprehensive care plan established, implemented, revised, or monitored

CPT 99487 – $94
Complex chronic care management services, with the following required elements:

  • Multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient
  • Chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline
  • Establishment or substantial revision of a comprehensive care plan
  • Moderate or high complexity medical decision making
  • 60 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month

CPT 99489 – $47
Each additional 30 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (List separately in addition to code for primary procedure)

HCPCS G0506 – $64
Comprehensive assessment of and care planning for patients requiring chronic care management services (list separately in addition to code for primary procedure)

TRANSITIONAL CARE MANAGEMENT

CPT 99495 – $165
Transitional care management services with moderate medical decision complexity (face-to-face visit within 14 days of discharge)

CPT 99496 – $234
Transitional care management services with high medical decision complexity (face-to-face visit within 7 days of discharge)

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