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The Medek Remote Patient Monitoring Billing Queue

By Matt Furnari

Probably the most useful feature of the Medek RPM Doctor Portal is the billing queue. When new customers see the billing queue, they are shocked by its ease of use. Especially if they’ve worked with some of our competitors’ products. Billing for remote patient monitoring can be an intensely time-consuming and complex process.

Part of the problem is that the CPT® Billing Codes are written in such a way that it’s confusing when you can bill. There is quite a bit of accounting to do just to figure out when something is available to bill. It can be difficult to know when something is billable vs. not billable. 

For example, CPT® Code 99453 is billable as soon as a device is set up. But, it can only be billed once. CPT® Code 99454 is billable after 15 days of readings or alerts. Many people are confused by that “or alerts” piece and fail to bill CPT® Code 99454 in a timely manner. CPT® Code 99457 and CPT® Code 99458 are both billable after a minimum threshold of review minutes has been hit. However, the biller must be careful to allocate minutes correctly across the two codes as the time is shared. 

To add further complexity,  the billing cycles for CPT® Codes 99453, 99454, 99457, and 99458 are different. CPT® Code 99453 is billable once. 99454 is available every 30 days. 99457 and 99458 are available on a monthly cycle. Why is 99454 billable every 30 days, but 99457 and 99458 are billable once per month? Who knows!

A lot of our competitor products dump all this complexity into your lap. You get spreadsheets full of data that list readings and dates, and it’s up to you to figure out when to bill and how much to bill. Others try to simplify the process. For example, treating CPT® Code 99454 as a monthly code simplifies the process. But that’s wrong! You would be throwing money away!

There are more 30-day cycles in a year than they are months. There are 12.175 thirty-day cycles in a year and only 12 months. Who cares about 0.175, right? 

Wrong! With a practice of 100 patients you’re missing out on approximately 16 billing cycles per year. That adds up. That can be over $800 of extra revenue per year

It can be even more challenging when patients are onboarded throughout the month. Every patient can have a different start date and different 30 day cycle. Some may achieve their 99457 the first month, and others may not. 

It can be overwhelming!

The job of software is to make life easier. The absolute beauty of the Medek Remote Patient Monitoring billing queue is that it takes care of all this complexity for you. 

  • You don’t need to worry about billing cycles
  • You don’t need to worry about start dates
  • You don’t need to worry about thresholds and alerts, and readings

Everything happens for you, instantly, 24 hours a day. You or your billing team simply go to the billing queue. Every available billing code for every available patient is ready to be billed. There’s no thinking.  There’s no pulling of reports. There’s no trying to figure out dates. Everything is done for you automatically. Moreover, we make sure you get every single penny by billing exactly as the laws written. We didn’t take any shortcuts to try to simplify the problem we make sure that every patient, every reading, every day it’s billed appropriately so, you get the most money back

The billing queue is one of the reasons we can say dollar for dollar, you get the best bang for your buck with Medek RPM. Begin a conversation with a Medek Representative today to see how it will benefit your patients and your practice. 

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

The American Medical Association (AMA) is considering a significant overhaul and expansion of Remote Patient Monitoring (RPM) Current Procedural Terminology (CPT™) codes.

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