What Does CPT Code 99453 Cover?

CPT Code 99453 reimburses for the setup and patient education associated with remote patient monitoring. This includes:

• Initial device setup
• Patient education on device use
• Ensuring the device transmits data correctly
• Establishing connectivity between the device and the provider’s system

With CCN Health’s integration with DS Smart and PCC, this process is effortless—ensuring compliance while eliminating manual data entry.

Which RPM Devices Qualify for CPT Code 99453?

To bill CPT Code 99453, healthcare providers must use FDA-defined medical devices that collect and transmit physiological data. Common RPM devices include:

• Blood pressure monitors
• Weight scales
• Blood glucose meters
• Pulse oximeters
• Peak flow meters

CCN Health ensures seamless device integration with DS Smart, so vital sign data is automatically transmitted without manual input.

Who Qualifies for CPT Code 99453?

CMS allows Medicare patients with chronic or acute conditions to participate in RPM programs. This means providers can bill CPT Code 99453 for any Medicare patient requiring continuous remote monitoring.

What Is the Reimbursement Rate for CPT Code 99453?

As of 2024, the national average reimbursement rate for CPT Code 99453 is $19.73. This rate may vary based on geographic adjustments.

Billing Requirements for CPT Code 99453

To bill CPT 99453, providers must meet the following criteria:

• The RPM device must meet FDA’s definition of a medical device.
• Patients must opt into RPM services before device activation.
• The device must be used for at least 16 days within a 30-day billing period.
• Data collection and transmission must be HIPAA-compliant.

How Often Can CPT 99453 Be Billed?

CPT Code 99453 is billed once per patient per episode of care, provided the device collects and transmits data for at least 16 days in a 30-day period.

Do RPM Devices Need FDA Clearance for CPT 99453 Billing?

CMS states that RPM devices must be classified as medical devices per the FDA. Some providers require FDA-cleared Class II devices, but FDA approval is only necessary for Class III devices (e.g., implantable pacemakers).

For CCN Health users, our platform ensures all device integrations align with CMS and FDA compliance requirements.

Can a Third-Party Deliver RPM Services for CPT 99453?

Yes. Providers can bill CPT Code 99453 under “incident to” billing, allowing third-party RPM companies to assist with setup, device activation, and patient education.

With CCN Health, healthcare providers can streamline their RPM workflow, reducing administrative burdens while ensuring compliance and reimbursement.

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