CPT Code 99458 – Remote Patient Monitoring Guide

CPT Code 99458 is a remote patient monitoring billing code used to reimburse practices for remote care services through Medicare. CPT Code 99458 varies slightly from other codes as it is considered an add-on to CPT Code 99457, rather than being considered a stand alone code. In order to qualify for reimbursement for CPT Code 99458, physicians must first meet the 20 minutes of service requirement for CPT Code 99457, then bill for each following additional 20 minutes of service. This code helps to provide for practices who support remote patients with extra care and additional services by allowing practices to bill for services provided beyond the required 20 minutes. Remote patient monitoring companies such as 100Plus make interactive remote patient care necessary for Medicare reimbursement easy and accessible.

Here is everything you need to know about CPT Code 99458, from billing to payment.

What is CPT Code 99458?

CPT Code 99458 is the billing code for each additional 20 minutes of clinical staff time and interactive communication for a patient’s remote patient monitoring program.  Code 99458 varies slightly from other codes as it is considered an add-on to CPT Code 99457, rather than being considered a standalone code.

To qualify for reimbursement for Code 99458, physicians must first meet the 20 minutes of service requirement for Code 99457, then bill for each following additional 20 minutes of service. This code helps to provide for practices who support remote patients with extra care and additional services by allowing practices to bill for services provided beyond the required 20 minutes.

What services are required to bill code 99458?

Similar to CPT Code 99457, Code 99458 requires interactive communication in order to be added on to reimbursements. This interactive communication 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.” Additionally, the CMS clarified that the 20 minutes of service time required to bill for both 99457 and 99458 “should include care management services and synchronous, real-time interactions.” However, the same interactive communication documented for 99457 can also satisfy the interaction for 99458.

Is a separate instance of interactive communication required for 99458?

No, the interactive communication documented within 99457 also applies to 99458.

What devices are used for CPT Code 99458?

The major devices used for code 99458 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 99458?

No, code 99458 is independent of code 99454 and 16 days of readings.