Remote therapeutic monitoring and remote patient monitoring both play vital roles in creating and managing comprehensive care plans for patients. This guide will navigate remote patient monitoring Medicare and remote therapeutic monitoring codes, with an emphasis on remote patient monitoring guidelines.
Remote Therapeutic Monitoring vs Remote Patient Monitoring
Remote therapeutic monitoring (TPM) and remote patient monitoring (RPM) share the goal of collecting data in real-time to adapt care plans as necessary; however, the key difference between these methods is the type of data they gather and analyze. Remote therapeutic monitoring focuses primarily on non-physiological data, such as exercise habits and patient pain levels. In contrast, remote patient monitoring collects and analyzes physiological data like blood glucose levels and cardiovascular performance.
Does CMS Reimburse for Remote Patient Monitoring?
CMS does reimburse care providers for RPM equipment and management. However, coverage is contingent on specific requirements for Medicare, and coverage from Medicaid and private insurance companies varies from state to state.
To ensure your care center can provide CMS-compliant remote patient monitoring services, partner with an organization that values compliance, simplicity, and quality.
Learn More about the CMS Guidelines for Remote Patient Monitoring →
Remote Therapeutic Monitoring CPT Codes
The CPT codes for remote therapeutic monitoring are 98975, 98976, 98977, 98980, and 98981. These codes cover remote therapeutic monitoring equipment, system setup, patient education, and care management services.
Remote Patient Monitoring CPT Codes
The CPT remote patient monitoring codes include 99453, 99454, 99457, 99458, 99473, 99474, 99091, 95250, 95249, and 95251. The American College of Physicians provides the following details for each CPT code:
- 99453: Initial setup and education for equipment
- 99454: Results delivery and reporting
- 99457: Physician’s interpretation and patient interaction for the first 20 minutes during the billing period
- 99458: Subsequent 20 minutes of interpretation and patient interaction during the billing period
- 99473: Initial setup and education for equipment specifically for self-measured blood pressure monitoring (SMBP)
- 99474: Ongoing treatment decisions regarding SMBP
- 99091: Physiologic data collection and interpretation
- 95250: Ambulatory CGM equipment, setup, training, data collection, and reporting
- 95249: Ambulatory CGM when patient provided equipment is used
- 95251: Analysis, interpretation, and reporting not covered by 99091
Proposed changes to remote patient monitoring billing guidelines include RPM services within code G0511 for rural health clinics (RHCs) and federally qualified health centers (FQHCs). Learn more in our guide to The 2024 CMS Proposed Rule.
Meet Remote Monitoring Guidelines for Medicare with TimeDoc Health
To deliver the best care for patients, your practice needs RPM services that run efficiently and bring in revenue. Aligning remote patient monitoring systems with CMS requirements is necessary for achieving these goals, and with TimeDoc Health, you can ensure compliance and efficiency every step of the way. Our platform and supplementary services provide:
- FDA-approved devices
- Automatic data collection in real-time
- Customizable alert settings
- Support from clinical care experts
Contact us to learn more about how Time Doc Health’s RPM platform can transform your remote patient monitoring services.
