What Are the CPT Codes for RPM?

RPM billing typically involves the following Current Procedural Terminology (CPT) codes:

Who Can Bill RPM Services?

RPM services can be billed by the following qualified healthcare professionals:

• Physicians (MD/DO)

• Nurse Practitioners (NP)

• Physician Assistants (PA)

• Certified Nurse Midwives (CNM)

Clinical staff (e.g. RNs, care coordinators) may furnish services incident to a billing provider, under general supervision, as permitted by CMS.

RPM Device Requirements

To bill CPT code 99454, the device must meet the following criteria:

• Be classified as a medical device according to the FDA definition

• Automatically transmit patient data (self-reporting is not allowed)

• Record and upload data on at least 16 unique days within a 30-day period

Common eligible devices include: - Cellular-enabled blood pressure cuffs - Glucose meters - Pulse oximeters - Weight scales.

Billing Requirements and Best Practices

• 99453 may be billed once per patient per episode of care, after device setup and patient onboarding.

• 99454 is billable every 30 days, as long as data was received on ≥16 days.

• 99457 requires documentation of interactive communication (real-time conversation, phone or video) involving data interpretation.

• 99458 is billable for each additional 20-minute increment beyond the initial 20 minutes.

Tip: Use time-tracking tools and document interaction content to support 99457/99458 billing.

Sample Documentation Language

99457 Example:
“Reviewed 21 BP readings via cellular cuff; patient average 142/88. Contacted patient to discuss salt intake and adherence; 11-minute phone call. RPM interactive time this month: 24 minutes.”

99454 Example:
“Device transmitted 19 days of glucose data (Feb 1–Feb 28); patient met threshold for monthly billing.”

RPM Billing Quick Reference

• 99453: Use once after onboarding

• 99454: ≥16 days of device data in 30-day period

• 99457: Must document 20 minutes of interactive communication

• 99458: Optional; each additional 20 minutes must be distinct and documented

Reminder: RPM codes cannot be billed in the same month as certain other services (e.g., if time or tasks overlap with CCM).

Frequently Asked Questions

1. Can I bill 99453 and 99454 in the same month?
   Yes, 99453 is billed once at the beginning of the RPM episode; 99454 can be billed monthly as long as device criteria are met.
   
   

2. Do patients need to consent to RPM?
   Yes, Document verbal or written consent in the medical record before initiating services.
   
   

3. Does the patient need to use the device every day?
   No, but RPM billing (99454) requires data on at least 16 unique days in a 30-day period.
   
   

4. Can clinical staff deliver RPM services?
   Yes, under general supervision of the billing provider and following CMS incident-to rules.

   
   

Ready to Implement RPM?

Let us help you get started. OnCare360’s RPM program includes FDA-compliant devices, patient onboarding support, clinical protocols, and billing assistance.

Contact us today for a tailored strategy session.