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Your Guide To The New CPT Codes

The 2020 CPT codes for remote patient monitoring (RPM) and ketone testing are available to support adherence to clinical programs using the BIOSENSE device, indicated for in-home ketone testing. The Centers for Medicare and Medicaid Services recognize the importance of remote patient monitoring services, and the power it has to minimize the gaps in our current healthcare system.  

While CMS has not specified which types of technology are covered under the new CPT codes, the device used must be a medical device as defined by the FDA. 

Here’s a quick and easy guide to the new CPT codes and the national average Medicare payment. 

Code Description National Average
99453
Remote monitoring of physiological parameters

One-time initial device setup for onboarding patients including patient information
$21
99454
Device supply & programmed alert notification for 30-day period, billed monthly
$64
99091
Remote patient monitoring by physicians and QHCP

30 minutes of professional time dedicated toward a patient per 30 day period
$59
--------------------------OR---------------------------
99457
Remote physiological monitoring by clinical staff, MD, or QHCP first 20 minutes; interactive communication
$54
99458
Remote physiological monitoring by clinical staff, MD, or QHCP additional 20 minutes; interactive communication
$43

* 99457 and 99091 cannot be billed concurrently

2020 Reimbursement Codes

BIOSENSE Data Flow

Two Options:

Option A

BIOSENSE provides feedback all day to promote adherence through its mobile app sharing function from patient to clinician. This personalized full-day exposure of ketone measurements allows clinicians to view patient nutritional ketosis data over a select period. 

The daily, weekly and monthly views show an individual’s AUC where the depth and duration in nutritional ketosis are revealed. This data provides health care professionals with a tool to assist patients with better health outcomes, specifically related to their metabolic wellness. 

Option B

Use of partner applications with multi-patient platforms. BIOSENSE seamlessly integrates with the following applications (typically fee-based). 

Questions? Please contact us at support@readouthealth.com.