RPM: Remote Patient Monitoring
Remote Patient Monitoring (RPM) uses digital health technology to collect physiological data from patients in non-clinical settings, with Medicare providing structured reimbursement through four dedicated CPT codes.
What is RPM?
Remote Patient Monitoring (RPM) involves the use of connected medical devices — such as blood pressure cuffs, glucose monitors, pulse oximeters, weight scales, and cardiac rhythm monitors — to collect patient physiological data outside of traditional clinical settings. The data is transmitted electronically to the clinical team, enabling ongoing monitoring and intervention without requiring the patient to travel to a clinical site.
Medicare RPM CPT Codes
- CPT 99453: Initial device setup and patient education (~$19). Billed once per device, per episode of care
- CPT 99454: Device supply with daily recording or programmed alert transmission — requires 16+ days of data in 30-day period (~$55/month). This is the device/compliance code
- CPT 99457: RPM treatment management — first 20 minutes of interactive communication per calendar month (~$51/month). Requires real-time interactive communication with the patient
- CPT 99458: Each additional 20 minutes of RPM treatment management per calendar month (~$41/month)
Device Compliance Requirement
A critical billing requirement for CPT 99454 is that the device must transmit data on at least 16 days within the 30-day billing period. This 16-day threshold is the single most common reason for RPM revenue shortfalls — patients with poor device compliance generate device costs without billable supply codes. Proactive monitoring of device compliance rates by patient and by month is essential to RPM programme profitability.
Revenue Potential and Programme Economics
A fully compliant RPM patient generating all four codes (99453 + 99454 + 99457 + 99458 in setup month) can generate approximately $165–185 in the first month and $145–165 in subsequent months. For a programme managing 200 patients at 80% compliance, annual RPM revenue reaches approximately $280,000–320,000. Analytics tracking compliance rates, time documentation, and per-patient revenue generation are essential for programme sustainability.