Number of Patients per Physician annually: (5000 Latest Industry Average as per Physicianleaders.org):
Number of Physicians:
Number of Medicare Eligible Patients (annually):
An estimated number of Medicare Patients (annually):
% of Medicare Patients with 2 or more Chronic Conditions (annually):
% of Medicare Patients Eligible for RPM (annually):
Expected Number of Patients expected to opt for RPM (as a % annually):
Estimated Number of Patients You Expect to Opt-In (annually):
Set-up, patient instructions and education regarding the use of RPM equipment: Remote monitoring of physiologic parameter(s) (e.g., weight, blood pressure, pulse oximetry, respiratory flow rate).
Device(s) supply with daily recording or programmed-alert transmissions: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days
Remote monitoring treatment/interactive services: Remote physiologic monitoring treatment management services that require 20 minutes or more of live (non-face-to-face), interactive communication (e.g. monitoring, etc.) between the patient/caregiver and the clinical staff/ physician/other qualified healthcare professional’s time in a calendar month.
Reported in conjunction with 99457 to report each additional 20 minutes of time: Remote physiologic monitoring treatment management services that require 20 minutes or more of live (non-face-to-face), interactive communication (e.g. monitoring etc.) between the patient/caregiver and the clinical staff/physician/other qualified healthcare professional’s time in a calendar month.
Collection and interpretation of physiologic data (e.g. ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified healthcare professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time in a calendar month.
*For patients with two or more chronic medical conditions expected to persist for more than 12 months following diagnosis and place the patient at an increased risk for hospitalization.
Minimum 60 cumulative minutes over a 30-day period of non-face-toface consultation time establishing or monitoring a care plan
For every additional 30 minutes non face-to-face consultation (with 99487)
Chronic care management services with the following required elements: multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient, chronic conditions place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline, comprehensive care plan established, implemented, revised, or monitored; first 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month
Chronic care management services, each additional 20 minutes of clinical staff time directed by a physician or other qualified healthcare professional, per calendar month
Additionally, doctors can receive reimbursements for Telehealth services provided. These codes include G0316, G0317, G0318, G3002, and G3003.
The reimbursement amount for these codes is based on the Medicare Physician Fee Schedule (MPFS) and varies depending on the service provided and the geographic location of the provider
Check or Uncheck RPM CPT codes and CCM codes to see how this adjusts. (Time requirements 20 minutes RPM and 20 Minutes CCM)
Gross Revenue Minus 20% Co-Pay. Per Year, excluding one-time setup code 99453. CMS states an office must attempt to collect a 20% co-pay per month per patient for RPM services.