Scale Your Clinic’s Chronic Care — Without Adding Staff
CPT Billing Codes
Billable One Time Only
Device setup and patient education.
Can be charged once per episode of care after 16 readings of data has transmitted.
Recurring – Billable Once per 30-day period
Provider supplied device for recording and data transmission of biometric data. If a patient uses the device 16 or more unique days per month.
Clinics may bill either CPT 99445 or CPT 99454 in a given month – not both.
Recurring – Billable Once per Calendar Month
Covers 20–39 minutes per calendar month of staff time spent monitoring physiologic data and actively communicating with the patient or caregiver.
Recurring – Billable Once per Calendar Month
Covers each additional 20-minute increment of RPM treatment management time beyond CPT 99457.
CPT 99458 may only be billed in conjunction with CPT 99457 and cannot be billed with CPT 99470 and is limited to two units per calendar month.
Recurring – Billable Once per 30-Day period
Provider supplied device for recording and data transmission of biometric data. If a patient uses the device 2-15 unique days per month.
Clinics may bill either CPT 99445 or CPT 99454 in a given month – not both.
Recurring – Billable Once per Calendar Month
Covers 10–19 minutes per calendar month of staff time spent monitoring physiologic data and actively communicating with the patient or caregiver.
CPT 99470 is a standalone treatment management code and may not be combined with CPT 99457 or CPT 99458 in the same calendar month.
Recurring – Billable Once per Calendar Month
Clinical staff provides services meeting all the required elements of APCM services, for any patient, under guidance of a physician or qualified health professional responsible for the patient’s primary care needs.
Recurring – Billable Once per Calendar Month
Services as described in G0556, for a patient with at least two chronic conditions expected to last at least 12 months, or until the death of the patient.
Recurring – Billable Once per Calendar Month
Services as described in G0557 for a patient that is a Qualified Medicare Beneficiary (QMB).
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