CPT 99091 can be billed by a physician or qualified health professional (QHP) collecting, reviewing, interpreting, and reporting of physiologic data (e.g., blood pressure, glucose, pulse, weight) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other QHCP for a minimum of 30 minutes of time spent, each 30 days. (approx. $54.22)
- Patient identification, enrollment, treatment plan creation, and ongoing care management
- Turnkey Services available at client’s request to utilize CareVitality’s Care Team
- Compliance built-in system to ensure all RPM requirements are met prior to billing
- Audit proof – Automated coding and billing
- Top notch cyber security embedded in the platform to keep your patient data secure
- No upfront costs. Payment is based on performance. We are paid once you are paid.
- Integration with existing Health IT platform(s) (ie EHR, Billing & Scheduling systems)
- Add-ons: Chronic Care, General Care, Principal Care, Transitional Care & Behavioral Health
- Patient identification, enrollment, treatment plan creation, and ongoing care management
- Turnkey Services available at client’s request to utilize CareVitality’s Care Team
- Compliance built-in system to ensure all RPM requirements are met prior to billing
- Audit proof – Automated coding and billing
- Top notch cyber security embedded in the platform to keep your patient data secure
- No upfront costs. Payment is based on performance. We are paid once you are paid.
- Integration with existing Health IT platform(s) (ie EHR, Billing & Scheduling systems)
- Add-ons: Chronic Care, General Care, Principal Care, Transitional Care & Behavioral Health
- Chronic Care Management (CCM)
- Principal Care Management (Specialty Care) (PCM)
- Behavioral Health Integration (BHI)
- Wellness Visits / Health Risk Assessments (AWV, IPPE, HRA)
- Transitional Care Management (TCM)
- Remote Patient Monitoring (RPM)
- General Care Management (GCM)
- Utilize CareVitality’s platform and care team
- Utilize CareVitality’s platform and your care team as well as ours
- Utilize your own platform & CareVitality’s care team
- License CareVitality’s platform
Definition of Medical Device
Medical devices that digitally collect and transmit a patient’s physiologic data must be reasonable and necessary for the diagnosis or treatment of the patient’s illness or injury or to improve the functioning of a malformed body member. The device must meet the FDA’s definition of medical device 201(h) of Federal, Food, Drug, and Cosmetic Act; however, it does not have to be FDA-cleared/registered. The devices must digitally (automatically) upload patient physiologic data and cannot be recorded or reported by the patient. Medical devices must be used to collect and transmit reliable and valid physiologic data that helps describes the patients’ health status to develop and manage a plan of treatment.
What Are the Remote Physiologic Monitoring CPT Codes?
Collecting and Analyzing Physiologic Data by a provider
Providing Set-up and Training of device
All auxiliary personnel (including clinical staff and non-clinical) may provide education to patients on RPM services and set up of the remote physiologic device under CPT code 99453. The personnel can be either contracted or employed by the billing practitioner. This means that RPM vendors can provide the education and set-up of the device. (approx. $19.32)
CPT code 99453 can be billed only once per episode of care where an episode of care is defined as “beginning when the remote physiologic monitoring service is initiated and ends with attainment of targeted treatment goals.
– (CPT Codebook, p. 52).
16 Days of Monitoring
To bill for the collection and continued monitoring of the remote physiologic device(s). This monitoring must occur over at least 16-days of a 30-day period. RPM services can only be billed by one practitioner per 30-day period and cannot be reported for a patient more than once during a 30- day period (even when multiple medical devices are provided to a patient). (approx. $50.15)
Collecting & Analyzing Physiologic Data by clinical staff (initial time)
Remote physiologic monitoring (RPM) services involve the collection, analysis, and interpretation of digitally collected physiologic data by managing of a patient under their treatment plan requiring interactive communication with the patient/caregiver during the month. CPT Code 99457 is billable for clinical staff/physician/other qualified professional time with a patient in a calendar month for 20 to 39 minutes. (approx. $48.80) The 20 minutes includes both synchronous, real-time interactions as well as non-face-to-face care management services.)
“Interactive communication” includes real-time synchronous, two-way audio interaction that is capable of being enhanced with video or other kinds of data transmission.
Collecting & Analyzing Physiologic Data by clinical staff (add on time)
Subsequent 20 minutes of remote physiologic monitoring (RPM) services requiring interactive communication with the patient/caregiver during the month. CPT Code 99458 is billable along with for CPT 99457 for clinical staff/physician/other qualified professional time with a patient in a calendar month for each additional 20 minutes up to 2 units. (approx. $39.65)
Since using CareVitality’s Virtual Care Management team we have not only increased revenue to our office from additional reimbursement for the CCM service codes but our MACRA/ MIPS score has increased due to the additional support they provide to help us improve our patients outcomes by providing these services in between their office visits or…
Working with CareVitality’s Care Management team has not disrupted our workflow and has improved the care we provide to our patients. They identify themselves as part of our practice and use a caller id with our practice name and phone number similar to our office to provide seamless services to our patients.
CareVitality’s Virtual Care Management team is well rounded in both medical, mental health and behavioral health services to complete comprehensive care plans to service our patients. The RNs we have worked with have had 30+ years of nursing experience and have been detailed in their work that when it comes to our providers to review…
CareVitaity’s Virtual Care Managers have helped us successfully implement our Chronic Care Management Program. Their detailed understanding of how to successfully launch a chronic care management program along with their Virtual Care Managers explaining to the patient the benefits of receiving chronic care management services coupled with putting together a comprehensive patient centric care plan…
We have used CareVitality for two years now to attest our MIPS/MACRA and they have done a great job! I would recommend them for any service they provide.
Care Vitality is an efficient Chronic Care Management company. Vanessa is very knowledgeable and the company provides conferencing and reports that will keep a Medical Practice up-to-date with the latest information from onboarding employees to CMS rules. I highly recommend Chronic Care Management for their efficiency, professionalism, and knowledge !!!
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