Source: AMA CPT Professional Edition 2022
Used to report remote physiologic monitoring services (eg, weight, blood pressure pulse oximetry) during a 30-day period.
The service must be ordered by a physician or other qualified healthcare professional.
The device used must be a medical device as defined by the FDA.
May be used to report supply of the device for daily recording or programmed alert transmissions.
Not reported if monitoring is less than 16 days.
Reported only once per patient per 30-day period, even if the patient has multiple devices capable of remote monitoring.
Source: CMS, 12/1/2020
Auxiliary personnel may provide 99454 services incident to the billing practitioner’s services and under their supervision. Auxiliary personnel may include contracted employees.
Consent to receive RPM services may be obtained at the time that RPM services are furnished.
RPM services may be medically necessary for patients with acute conditions as well as patients with chronic conditions.
Physicians and NPPs who are eligible to furnish E/M services may bill RPM services.
*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.