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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