CPT Code 99457 – Remote Patient Monitoring Guide

CPT Code 99457 is the billing code for the initial 20 minutes of clinical staff time and interactive communication for a patient’s remote patient monitoring program. This code is billed every calendar month, rather than on a 30-day rolling cycle. 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 99457, from billing to payment.

What is CPT Code 99457?

CPT Code 99454 is the billing code for the first 20 minutes of clinical staff time and interactive communication for a patient’s remote patient monitoring program. Unlike CPT 99453, it is billed every calendar month instead of a rolling 30-day cycle.

What services are required to bill Code 99457?

Code 99457 requires 20 minutes or more of monitoring time by clinical staff, physician, or other qualified healthcare professional. This code requires interactive communication with the patient and is defined as “a conversation occurring in real time that includes synchronous, two-way interactions that can be enhanced with video or other kinds of data.”  While interactive communication contributes to the required 20 minutes, it is not the only activity that should be included in the total time as overall care management can contribute as well.

Are 20 minutes of interactive communication required for CPT 99457?

No, the 20 minutes does not have to be all interactive communication, just a component of it.

What if I don’t have the time or staff capacity to dedicate to monitoring patients?

100Plus offers clinical monitoring and can take this workload off your plate! Our in-house nursing team can take care of your patients, while minimizing escalations to you and your practice staff.

What devices are used for CPT Code 99457?

The major devices used for code 99457 are:

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

Does a patient have to have 16 days of readings to bill Code 99457?

No, code 99457 (and the add-on code 99458) is  independent of code 99454 and 16 days of readings.