Medicare providers can now get reimbursed for providing devices and monitoring patient physiologic measures remotely. Starting in 2019 there were three new codes which replace the previously impractical 99091. This is similar to Chronic Care Management (CCM) services.
- 99453 Set Up $21
- 99454 Supply Device $69
- 99457 Interactive Communication $54
99453 Set up $21
This code is paid once for initially setting up remote monitoring equipment and instructing the patient in its use.
99454 Supply Device $69 monthly
This code is paid monthly for every month the patient is supplied with remote monitoring equipment. The equipment must either make daily recordings or be programmed to transmit alerts based on predetermined values of measured parameters. There is very little specific information currently available about the details. CMS has listed a few possible measures as examples, but it seems this code is not limited to: blood pressure, weight, pulse ox, and respiratory flow rate. This code is billed each 30 days you provide the equipment. It seems that FDA approved Bluetooth-enabled blood pressure cuffs, pulse ox, and scales would satisfy this code.
It would be well worthwhile for primary care practices to purchase Bluetooth-enabled blood pressure cuffs for $100 or less and supply them to patients at this monthly reimbursement. We have been setting up patients with a blood pressure cuff which communicates BP readings electronically. The same information for heart rate is also provided. By purchasing the units at a bulk discount, the cost of the individual unit is nearly covered with the first month’s “set up’ and ‘device supply” payments.
“… the cost of the individual unit is nearly covered with the first month’s “set up” and “device supply” payments.”
99457 Interactive Communication $54 Monthly
This code appears to be very similar to a Chronic Care Management call where the transmitted data is reviewed and communication occurs with the patient. Like CCM, 20 minutes total of staff time must be spent per month to bill this code. Interestingly, it pays $11/month more than CCM. It can also be used in conjunction with CCM if you can spend 20 minutes on their RPM problem and still spend 20 minutes addressing their other CCM conditions. The CCM Pays Toolkit templates help provide structure to guide office personnel in reviewing charts and speaking with patients. Even if the full time is not spent for both RPM and CCM, being sure to complete 20 minutes with RPM with earn $11 more than if just CCM were completed.
Data from the First 5 Months
We reviewed the data from our first 5 months of use of the Qardio Arm device for blood pressure monitoring in RPM patients. We started 10 patients in the month of February. In mid-July, we compared their initial blood pressure reading to the 30 day average. Their average systolic pressure had decreased 19 points, and their average diastolic pressure had decreased 12 points.
“… average systolic pressure had decreased 19 points.”