CPT Code 99454 – Remote Patient Monitoring Guide

CPT Code 99454 is the billing code for supplying and monitoring patients with remote patient monitoring devices. The code reimburses providers for the continuous supply of devices and remote patient monitoring. This code can be billed monthly, but only once per patient, per month, regardless of how many devices the patient has. CPT Code 99454 comes with a unique set of rules and qualifications broken down here in this comprehensive guide.

Here is everything you need to know about CPT Code 99454, from billing to payment.

What is CPT Code 99454?

CPT Code 99454 is the billing code for supplying and monitoring patients’ RPM devices. The code reimburses providers for the continuous supply of devices and transmission. This code can be billed once per 30-day period, once per patient, regardless of how many devices the patient has. This code cannot be billed if the patient has less than 16 days of readings in the 30-day period.

When can I bill for CPT Code 99454?

This code can be billed once per 30-day period, once per patient, regardless of how many devices the patient has. This code can only be billed when the patient has 16 or more days of readings in the 30-day period.

Can a single patient have multiple RPM devices under CPT 99454?

A single patient can have multiple RPM devices under the CPT Code 99454, but providers can only bill once per patient per 30 days period, and only when at least 16 days of patient data has been recorded, even when multiple devices are supplied to a single patient.

What devices are used for CPT Code 99454?

The major devices used for code 99454 are:

• Blood Pressure Cuff
• Pulse Oximeter
• Blood Glucose Monitor
• Digital Weight Scale

Do RPM devices have to be FDA certified for CPT 99454?

The Centers for Medicare and Medicaid Services has not stated the specific types of technology or devices that apply to CPT Code 95454 in the most recent CMS-1693-F final rule. The CMS has stated that the device must be a “medical device as defined by the FDA.” Medicare does not require the device to be “approved” or “cleared” by the FDA, but specific providers may require FDA approval for RPM devices.