What Services Are Billable Under CPT Code 99458?

CPT Code 99458 is an add-on code to CPT 99457, meaning it cannot be billed alone. Once a provider has completed 20 minutes of interactive RPM services under CPT 99457, additional 20-minute increments can be billed under CPT 99458.

✅ No additional live call required after the first 20 minutes (CPT 99457)

✅ Covers additional time spent reviewing patient data and coordinating care

✅ Must be documented properly to ensure compliance

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How Often Can CPT Code 99458 Be Billed?

Providers can bill CPT Code 99458 multiple times per month in 20-minute increments beyond the first 20 minutes covered under CPT 99457.

• Billing is unlimited, but CMS recommends staying within two additional units (totaling 60 minutes per month)
• Time must be properly documented to justify reimbursement

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What is the Reimbursement Rate for CPT Code 99458?

For 2024, the national average reimbursement for CPT Code 99458 is $38.50 per additional 20-minute increment.

💡 Example Billing Scenario:

• 20 minutes: Bill CPT 99457 ($47.88)
• 40 minutes total: Bill CPT 99457 + 99458 ($47.88 + $38.50)
• 60 minutes total: Bill CPT 99457 + 99458 (x2) ($47.88 + $38.50 + $38.50)

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Who Qualifies for RPM Services?

All Medicare beneficiaries qualify for RPM, but the following requirements must be met:

• The RPM device must be classified as a medical device per the FDA
• Patients must opt-in before receiving RPM services
• New patients require an evaluation before starting RPM
• Patients must use the RPM device for at least 16 days per month for CPT 99453 and 99454 billing
• All data collection and transmission must be HIPAA-compliant

With CCN Health, providers can ensure seamless compliance, eliminating manual documentation hassles.
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Who Can Deliver RPM Services Under CPT Code 99458?

CPT Code 99458 can be delivered under the general supervision of a physician or qualified healthcare provider. This means clinical staff and third-party RPM service providers can support patients under the supervision of the billing provider.

CCN Health enables providers to scale RPM services efficiently by handling data collection, device integration, and reimbursement management, ensuring compliance with CMS regulations.

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