The Centers for Medicare and Medicaid Services (CMS) released a technical correction in March after too much confusion surrounded CPT code 99457, one of the three remote patient monitoring CPT codes new to the 2019 Physician Fee Schedule Rule.

The correction clarified that CPT code 99457 may be billed as an “incident to” service, which expands its use beyond the physician alone. Now qualified medical professionals, under direct supervision, can also bill to 99457 and receive reimbursement for remote patient monitoring services relating to this code.

Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.

CPT Code 99457

When the codes were announced, commenters requested clarification since the CPT code description seemed to contradict the initial response from CMS of “We note that CPT code 99457 describes professional time and therefore cannot be furnished by auxiliary personnel incident to a practitioner’s professional services.”

CMS replaced its official response as “We thank commenters and confirm that these services may be furnished by auxiliary personnel incident to a practitioner’s professional service.”

With this clarification, medical professionals can bill more easily to CPT code 99457, along with CPT codes 99453 and 99454—all for remote patient monitoring reimbursement.

For more information on how to take advantage of ForaCare’s remote patient monitoring program, contact us.