Provider Support

Tips for Proper Billing

The information you need to know to understand billing.

• All patients need an order on file for RPM services. Order should include the diagnosis for the patient referred for RPM. Typically, an order or script for RPM services should be housed in the physician’s EHR
• A provider can only bill 99454 once per patient every 30 days regardless of the number of devices used.
• RPM must be conducted by a Qualified Health Care Professional, but codes 99457 and 99458 can be conducted under general supervision of the QHCP by other members of the care team.
• “Interactive communication” for purposes of CPT codes 99457 and 99458 requires, at a minimum, a real-time synchronous, two-way audio interaction that is capable of being enhanced with video or other kinds of data transmission.
• The duration of the “interactive communication” described above does not have a specific time requirement. For the monitoring time codes (99457 and 99458), interactive communication is one component of the overall 20 minutes of monitoring time.

Read More About Billing and Reimbursement

^{*Disclaimer: The guidance provided is for reference purposes only. Practitioners should ask properly trained and certified billing personnel to review claims prior to submission to confirm compliance with billing requirements for their specific scenarios.}