This step-by-step guide shows you how to bill for remote patient monitoring code 99458 correctly. CPT code 99458 enables practices to support remote patients with extra care and additional services while billing for these services in 20-minute increments. CPT code 99458 allows reimbursement for a qualified healthcare professional’s time monitoring data and engaging with patients during a 30-day period.
What Services Are Billable Under Code 99458?
CPT code 99458 differs from the other 5 remote patient monitoring codes (99453, 99454, 99457, and 99091) because it is considered an add-on to CPT Code 99457. Once a qualified healthcare professional has met with a patient for 20 minutes in real-time, they will bill the service under CPT code 99457. CPT code 99458 can only then be used for subsequent support needs. As long as the requirements for CPT code 99457 have been met, an additional live, synchronous call is not required to bill for 99458.
How Often Can CPT Code 99458 Be Billed?
99458 is billable monthly for unlimited additional 20-minute increments of clinical time. It is recommended that healthcare organizations stay within 2 units of time for 99458. As with CPT 99457, documentation of how the time is distributed is required.
What is the Reimbursement Rate for Code 99458?
The 2023 average national payment rate (rounded) for CPT 99458 is $38.64. As a reminder, CPT code 99458 is for additional time spent with a patient and is billable after a healthcare organization meets the initial requirements for CPT Code 99457.
Who Qualifies Under CPT Code 99458?
All Medicare beneficiaries may participate in remote patient monitoring. However, the following requirements must be met to bill for remote patient monitoring CPT codes in 2023.
- The RPM device must fit within the FDA’s definition of a medical device.
- A Patient must opt-in for the service before ordering the remote patient monitoring device.
- A patient evaluation is needed for patients new to RPM.
- Patients already enrolled in RPM during the Public Health Emergency (PHE) can continue receiving RPM services.
- The patient must use the RPM device for at least 16 days a month to bill for CPT codes 99453 and 99454.
- Data collection must be HIPAA-compliant.
Who Can Deliver Services for CPT Code 99458?
Services for 99458 can be completed under the general supervision of the primary physician. This means that other qualified employees within a practice can perform the services. Tenovi works exclusively with companies offering healthcare providers remote patient monitoring solutions. In addition, we serve RPM service and software, chronic care management, and telehealth companies. You can use the Tenovi dashboard or platform because we have well-supported data.
RPM provides better support between appointments so clinicians can better understand their patient’s conditions and provide timely care. Are you interested in learning more about how remote patient monitoring works at Tenovi? Join us for a free demo and consultation. Visit the Tenovi blog for more information about reimbursement, billing procedures, and how remote patient monitoring works.
