2022 Medicare CPT Code Reimbursements for Remote Patient Monitoring (RPM)
How did Medicare reimbursements for Remote Patient Monitoring (RPM) change for 2022?
In the 2022 Final Rule, CMS showed its support for telehealth and remote patient monitoring (RPM) with five new codes under the category remote therapeutic monitoring (RTM). While the remote monitoring landscape expands, CMS revised some key RPM CPT codes at a lower rate. Congress mitigated some of the impact on RPM reimbursements by effectively lifting the relative value unit (RVU) multiplier. It had been slated to drop a whole 1.30 in 2022 to 33.59. By intervening, Congress limited the reduction to about 30 cents per RVU. The new RVU multiplier for 2022 is set at 34.60. That’s the national rate; it varies slightly based on location.
How is RPM Different from Chronic Care Management (CCM)
The key difference between RPM and CCM is that RPM allows for providers to be reimbursed for remote treatment and management of patients using devices that collect essential physiologic data. These RPM CPT codes include reimbursement for both collection and interpretation of physiologic data from devices (e.g., scales, pulse oximeters, blood pressure cuffs, etc.). CMS also requires data from devices to be collected and transmitted electronically to bill for these codes, i.e., data cannot be self-reported by the patient. Here are the 2022 reimbursement rates for the existing RPM CPT codes:
| 2022 RPM Reimbursement Rates | ||
|---|---|---|
| CPT Code | What it Covers | 2022 RATE |
| 99453 | Initial setup of the device, including patient education on how to use it and how to connect it with other devices. | $19 |
| 99454 | Monthly remote monitoring with daily recordings. Billed each calendar month; must have a minimum of 16 days of monitoring. | $56 |
| 99457 | Monitoring and treatment management, which may include dialogue between patient or caregiver that totals at least 20 minutes during the calendar month. | $50 |
| 99458 | Each additional 20 minutes of monitoring and treatment management services provided. | $41 |
| 99091 | The time it takes for qualified clinical staff to gather, interpret and process monitoring data, at least 30 minutes every 30 days. Does not require interactive communication with patients. | $56 |
* All rates calculated using the 2022 RVU multiplier of 34.60 and total non-facility RVUs
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