1. Frequently Asked Questions (FAQs)
  2. General RPM Industry Questions

What is Current Procedural Terminology (CPT®) code 99457?

CPT® Code 99457 (and 99458) provide monthly reimbursement for the time your clinical staff spends monitoring data and engaging with patients.

CPT® Code 99457 (and 99458) provide monthly reimbursement for the time your clinical staff spends monitoring the data and engaging with patients.

Specific activities that count towards care team member time, include:

  • Monitoring and analyzing the data
  • Communicating with the patient, including health coaching and education
  • Discussing the patient’s case and treatment plan with other providers
  • Documenting notes in the patient’s record

You must accrue at least 20-minutes of time to bill 99457.  In addition, you must have at least one synchronous, two-way audio or video call with the patient.  This means you must actually speak to the patient – text messages and voicemails count towards the 20-minutes but do not meet the live, sync call requirement.  You must have both to bill 99457.

Monitoring can be done by clinical staff under general supervision of the billing provider, as defined by your state.

You can bill 99457 (and 99458) even if you have not met the requirements to bill 99454.