CPT 99454

CPT Code 99454 services cover continuous device supply and patient monitoring. This code also covers costs associated with leasing an RPM device.

All remote patients covered by Medicare qualify for CPT Code 99454. The expansion of the remote patient population that came with COVID-19 pandemic, allowed even more Medicare patients to qualify for these CPT codes.

The major devices used for code 99454 are:

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

For billing, CPT Code 99454 covers the monthly servicing costs of devices and treatment services.

Under CPT 99454, clinicians and physicians can be reimbursed $62.80 for supplying devices and monitoring.

Providers can get paid for their remote monitoring work by using the right CPT Codes. For CPT Code 99454, monthly billing for supplying devices and monitoring patients, the primary physician or clinician of the patient must order the devices. The primary physician or clinician also needs to provide invoices for the cost of the devices and services related to the devices. CPT Code 99454 requires 16 days of patient data readings during a 30-day billing period.

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.

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.

The work for each RPM service must be ordered by the patient’s physician or clinician and they must be monitored for at least 16 days before providers can bill for CPT Code 99454.

CPT Code 99454 can be billed every 30 days.

Use CPT Code 99454 to keep patients monitored and providers paid. With no hassle patient onboarding, no upfront costs, and full support for physicians, clinicians, and patients alike, 100Plus makes RPM easy.