CPT 99457 is billed for the first 20 minutes per calendar month of Remote Patient Monitoring (RPM) treatment management services. This code includes time spent by clinical staff, physicians, or other qualified health professionals and requires interactive communication with the patient, as established under the CY 2020 Medicare Physician Fee Schedule.
CPT 99457 supports the ongoing clinical management of patients enrolled in an RPM program and is reported on a monthly basis when all requirements are met.
What CPT 99457 Covers
CPT 99457 includes:
- 20 minutes per month of RPM treatment management time
- Ongoing review of RPM physiologic data
- Interactive communication with the patient related to RPM care
- Clinical activities necessary to manage and adjust treatment as appropriate
CPT 99457 Billing Requirements:
- Billed for the first 20 minutes per calendar month
- Requires interactive communication with the patient
- May be billed by clinical staff under general supervision
- Applies to ongoing RPM treatment management services
- Eligibility and participation requirements for RPM services have not changed
Resources:
CMS. Medicare Program; Revisions to Payment Policies under the Physician Fee Schedule and Other Revisions to Part B for CY 2020. November 2019. [Online: 11/01/2019].
https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/pfs-federal-regulation-notices-items/cms-1715-f Centers for Medicare & Medicaid Services