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AMA's Proposed Expansion of Remote Patient Monitoring CPT Codes: What You Need to Know

By Kathryn Jennings

The American Medical Association (AMA) is considering a significant overhaul and expansion of Remote Patient Monitoring (RPM) Current Procedural Terminology (CPT™) codes. These potential changes could have far-reaching implications for healthcare practices regarding revenue opportunities and patient care. Let's delve into what these proposed changes entail and how they may impact healthcare providers.

The upcoming CPT™ Editorial Panel meeting in May will address significant changes for RPM, as announced by the AMA.

Proposed Changes

  1. Addition of an RPM device supply CPT™ code 99XX4 for 2-15 days of collected and transmitted data
  2. Revision of CPT™ 99454 to include 16-30 calendar days.
  3. Revision of CPT™ 99457 to include 11-20 minutes of RPM care management time.
  4. Revision of CPT™ 99458 to cover each additional 10 minutes of interactive communication.

Changes to 99454: Addition of a new “device supply” CPT™ code

Why is this important? 

  • The current code, 99454, requires 16 days of transmitted readings or alerts. 
  • This requirement isn’t reasonable for certain conditions – like weight loss. 
  • This modification will simplify monthly compliance for patients.

Changes to 99457 and 99458 

Why is this important? 

  • Currently, you may only bill for exactly 20, 40, or 60 minutes of review time in a month. 
  • Any amount of time 1-19, 21-39, etc is “wasted time”, meaning it is not possible to obtain reimbursement
  • This change will reduce the amount of wasted time by providing more granularity. 

When you choose Medek RPM as your full-service provider

At Medek Health, we're committed to staying ahead of the curve, ready to adapt to any proposed billing changes to ensure our clients receive the best service possible. Here's why you should choose us:

  • Transparent Billing
    • We believe in transparency in billing. With Medek, you only pay for completed blocks of time. If we fall short by even a minute, you won't find it on your bill. We prioritize fairness and accuracy in our billing practices, giving you peace of mind.
  • Risk-Free Partnership
    • When you partner with Medek, you can rest assured that we take on all the risk. Our commitment to your success is unwavering, and we stand by our services. You can trust that we're fully invested in helping you achieve your goals without any financial burden on your end.
  • Industry-Leading Compliance
    • Medek Health boasts the highest compliance rate in the industry. With our remote patient monitoring services, you can trust that we'll deliver results and ensure that you get paid for the services you provide. We prioritize compliance to streamline the billing process and maximize your revenue.
  • No Upfront Charges for Devices
    • Unlike other providers, Medek will never charge you upfront for devices. We understand the importance of accessibility and affordability in healthcare, which is why we offer our monitoring devices without any upfront costs, making it easier for you to provide quality care to your patients.
  • No Charges for Incomplete Blocks or Extra Minutes
    • With Medek, you'll never be charged for incomplete blocks or extra minutes. Whether it's hitting those 20, 40, or 60-minute checkpoints, we take all the worry out of billing. Our commitment to accuracy means you can focus on patient care without any billing surprises.

Should you find yourself in need of guidance regarding the implications of remote patient monitoring CPT™ codes, please feel free to reach out to Medek. Our team of highly skilled professionals is available to provide you with unwavering support throughout the entire process, guaranteeing smooth integration and optimal utilization of remote patient monitoring in your practice.

 

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