CoachCare

Patient Volume


* Medicare universally covers RPM. Many commercial and other government payers cover it as well

Per Patient Economics

Program length will vary based on medical necessity but is typically 3-12 months. Adjust program length variable below as needed.



Annual Practice Revenue

RPM Overview - Insurance Codes

$18.84

one-time

CPT 99453

RPM Initial Setup & Patient Education

Reimbursement for the initial one-time cost of setting up and educating a patient on the use of RPM device and tools

$48.93

every 30 days

CPT 99454

RPM Device Supply

Reimbursement for supply of the RPM device. The device must be able to transmit patient data and/or alert on a daily basis and must be supplied to the patient by the billing provider

$47.61

monthly

CPT 99457

RPM Periodic Monitoring

Reimbursement for first 20 minutes spent by clinical staff monitoring patient remotely in a calendar month. Staff must also have at least one live interaction with the patient during the month, such as a phone or video call. There is no specific amount of time required for this interaction.

$38.68

Monthly (x2)

CPT 99458

RPM Periodic Monitoring

Reimbursement for additional 20 or 40 minutes spent by clinical staff monitoring patient remotely. No additional live interaction required.

NOTE: those are average Medicare rates 2022. Actual reimbursement varies by MAC locality . Private payers set their own rates and are not required to reimburse at the rates set by Medicare.

This article describes a feature used with the Remote Patient Monitoring (RPM) feature. The information and opinions contained herein are for general information purposes only, are not intended to constitute legal or other professional advice and should not be relied upon nor treated as a substitute for specific advice relevant to particular circumstances. We make no warranties, representations or undertakings about any of the content of this guide (including, without limitation, any as to the quality, accuracy, completeness or fitness for any particular purpose of such content), or any content referred to herein. We make no representations, warranties or guarantees, whether express or implied, that the content of this guide is accurate, complete or up-to-date.

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