Part of Remote Physiologic Monitoring
CPT 99457: RPM treatment management, first 20 minutes
First 20 minutes per calendar month of clinical staff or practitioner time reviewing RPM data and communicating with the patient.
Time threshold & code combinations
First 20 minutes of treatment management time, plus at least one interactive communication with the patient or caregiver, per calendar month.
- 99458 is the add-on for each additional 20 minutes beyond this threshold
- Mutually exclusive with 99470 for the same month: use 99470 if only 10-19 minutes were documented
Who can bill
- Physicians and non-physician practitioners
- Clinical staff under general supervision
Eligibility & billing requirements
- Active RPM episode with device data being collected during the month
- At least one interactive, real-time communication with the patient or caregiver during the month
- Time spent reviewing data and adjusting the care plan
When to use it
Monthly review and medication adjustment
A nurse spends 20 minutes reviewing a month of blood pressure trends, calls the patient to discuss a medication adjustment, and documents the conversation.
Billing: 99457
Documentation checklist
- Time log showing at least 20 minutes
- Record of the interactive communication (date, method, summary)
Common billing mistakes
- Billing 99457 without any interactive communication that month
- Rounding up time that didn't actually reach 20 minutes