2025 Medicare CPT Code Reimbursements for Remote Patient Monitoring (RPM)


This November, the Centers for Medicare and Medicaid Services (CMS) issued a Final Rule updating the Physician Fee Schedule. A list of prices, reimbursement rates, and billing codes for a variety of healthcare services and costs for remote patient monitoring (RPM) are all included in the report. Along with these changes, updates will be made to CCM reimbursements

Let’s review the Medicare and Medicaid reimbursements for remote patient monitoring (RPM).

How is Remote Patient Monitoring (RPM) different from Chronic Care Management (CCM)?

Let’s start by covering the differences between remote patient monitoring (RPM) and chronic care management (CCM). RPM providers gather data from their patients using remote devices. The codes for RPM allow providers to be reimbursed for monitoring these devices. 

Some devices providers may use for monitoring RPM patients may include: 

  • Blood pressure cuffs 
  • Weight scales 
  • Pulse oximeters 
  • Heart monitors 
  • Blood glucose monitors 

When looking for RPM reimbursements, it’s important to consider the following: 

  • RPM is home-based care, meaning patients receive care from home and are monitored at home instead of in a clinical setting. RPM allows patients and providers to overcome barriers related to transportation and many other factors to ensure high-quality care. 
  • Although this is home-based care, the data cannot be self-reported. CPT requires providers to collect and electronically transmit data from the aforementioned monitoring devices. 

Providers may be able to seek reimbursement for both RPM and CCM-related costs. Patients undergoing treatment for ongoing medical challenges may receive treatment in a clinical setting in addition to their at-home monitoring care. However, RPM codes apply specifically to the devices and treatments used remotely. 

Description of 2024-2025 RPM CPT Codes & Reimbursement Rates

Though the key CPT codes remain the same for 2025, a few have small updates due to inflation and Medicare budget considerations. Below is an updated look into these codes. 

2025 RPM Reimbursement Rates
CPT Code What it Covers 2025 RATE
99453 Initial setup of the remote monitoring device and educating the patient on how to use it, including connecting it to other devices, if needed. We require the technology used to monitor patients to comply with CMS standards. $20*
99454 Monthly remote monitoring with daily electronic recordings of physiological data from the patient. At a minimum, a provider must receive RPM recordings for 16 days during the 30-day period in which services are billed. We require the technology used to monitor patients to comply with CMS standards $47*
99457 Remote patient monitoring treatment & management that includes dialogue between the clinical staff and patient and lasts at least 20 minutes, billed per calendar month. $48*
99458 Each additional 20 minutes of patient monitoring treatment & management services provided, billed per calendar month. $39*
99091 Clinical providers can bill for the time spent collecting, interpreting, and processing physiological data from patients. Here, patients must receive RPM services for at least 30 minutes every 30 days. This does not require interactive communication with patients. $53*

The most notable update for RPM reimbursement that we will see in 2025: 

  • Expanded usage: In 2025, RPM will allow providers to monitor a broader set of conditions, including chronic and acute conditions in different settings.

 

*actual reimbursement varies by region.


Maximize Your RPM and CCM Model with Signallamp

Remote patient monitoring and chronic care management require an efficient and supportive infrastructure for both providers and patients, especially when handling billing responsibilities. With high patient loads and changing regulations, providers need support in order to provide effective RPM and CCM services to their patients. 

Signallamp is here to help. We provide the robust RPM and CCM support structure that providers need to sustain and grow their programs year over year. Signallamp helps providers take care further while maximizing their financial performance. With streamlined enrollment and consent, a team of trained and dedicated nurse care managers for monitoring and triage, and documentation directly into your EHR, the possibilities are endless. 

Are you ready to create a sustainable RPM program? Schedule a consultation with Signallamp today.


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