All about CPT code 99453 CMS. This CPT code is responsible for reimbursing the provider for supplying the patient with their RPM device. The Remote Patient Monitoring setup code, CPT Code 99453, pays clinicians for the time spent assisting patients with setting up and using their devices.
Remote patient monitoring: What is it?
As part of remote patient monitoring (CPT 99457, 99458 and 99454), patient physiological data are gathered and analyzed to create and manage a care plan for a chronic and acute sickness or condition. Patients should have a device that collects physiologic data, such as a blood-pressure cuff or oxygen levels monitor, and a gadget that transmits that data to their doctor to get services.
Which Services Are Necessary for CPT 99453?
For CPT 99453 cms, Medicare rules state the following: “Remote monitoring of physiological parameter(s), initial setup and patient education on device use,” e.g., “weight, blood pressure, pulse oximeter, respiratory flow rate.”
Medicare merely mandates that a member of the clinical or support staff working under the clinicians direction spend an indeterminate amount of time assisting the patient in setting up and becoming acquainted with their devices.
Does anyone meet the CMS requirements for 99453?
Medicare patients who would benefit from routine monitoring for acute or chronic diseases are eligible for remote patient monitoring. Before beginning services, providers must confirm that patients have satisfied the following conditions:
RPM services are available for new and current patients during the Covid-19 public health emergency. However, only established patients can access RPM services once the emergency is over.
As or even before the time services are provided, the provider or those performing RPM services for the provider get consent, which they must document.
A face-to-face initiating visit is required to enroll patients or patients who haven’t seen the practitioner in the previous 12 months. Only medical professionals and NPPs qualified to offer E/M services may bill.
What Equipment Is Associated With CPT Code 99453?
The two main types of equipment are used only for remote patient monitoring. Are listed below.
Devices that accurately assess patient physiologic data fall under the first group. These devices could include: Such gadgets should be FDA-recognized medical devices.
- Oximeter, Blood Pressure Cuff, and Pulse
- Monitor your heart rate
- Weighing scale
- Monitor for Respiratory Flow Rate
The second category of the gadget sends the supplier the data that has been gathered. There are various solutions available, most of which connect to the measurement equipment via Bluetooth and the provider’s portal via Wi-Fi and mobile data.
Would CPT Code 99453 Include the Cost of the Device?
No, CPT Code 99453 cms solely pays for the time expended instructing the patient on how to set up and use the equipment. Medicare does not compensate providers for the upfront costs of purchasing or delivering RPM devices.
Due to this reimbursement gap, starting an RPM program has proven difficult for many clinicians. It takes a lot of effort and money to identify measuring equipment, look for and buy the best transmission devices, and then give them to the patient. Because of this, providers should collaborate with a third-party supplier and services business that can offer affordable solutions.
This article has tried to give an overview of CPT Code 99453 cms. At DocsInk, we link the whole healthcare ecosystem, from major institutions and healthcare systems to clinics of every size and specialization. Regardless of the organization’s affiliation or available technology, we offer straightforward, efficient solutions that increase the delivery of high-quality patient care’s speed, efficiency, accuracy, and options.