Four CPT Codes, $170/Patient/Month When Fully Captured
Most practices capture 99453 and 99454 reliably. The lost revenue is almost always in 99457 and 99458 — where time tracking and documentation gaps cause systematic underbilling. Vizier tracks compliance thresholds for every code, for every patient, in real time.
Device Setup & Patient Education
Initial setup and patient education on device use and transmission. Billed once per patient per episode of care.
Device Supply with Daily Recording
16 days of data transmission required within a 30-day period. This threshold is the most common compliance failure in RPM programs.
Remote Physiologic Monitoring Treatment
Minimum 20 minutes of clinical staff interactive communication with patient per month. Live, synchronous contact required — asynchronous review alone does not qualify.
Additional 20-Minute Clinical Time
Each additional 20-minute increment of clinical time beyond the first 20 minutes. Must bill 99457 first. Significant revenue opportunity often left uncaptured.
The 16-Day Rule: Your Biggest RPM Revenue Risk
CPT 99454 requires 16 or more days of device data transmission within a 30-day period. Patients who submit readings on 15 of 30 days generate zero revenue for that month — even if all 15 readings were clinically reviewed and documented.
Vizier tracks each patient's daily transmission count in real time, identifies patients approaching day 20 without reaching 16 transmissions, and triggers automated outreach through your preferred channel — so you recapture compliant patients before the billing window closes.
The same logic applies to clinical time tracking for 99457 and 99458. If your care team has not yet reached 20 minutes of patient contact by day 25 of the month, Vizier surfaces that patient for a proactive outreach call to close the gap.
Who Belongs in Your RPM Program
RPM demonstrates the strongest clinical and financial outcomes in patients aged 65 and above with at least one chronic condition — particularly hypertension, diabetes, heart failure, and COPD. Medicare covers RPM under Part B for these patients without requiring a separate enrollment form or beneficiary cost-sharing beyond standard Part B coinsurance.
Vizier analyzes your patient panel and identifies every patient who meets clinical eligibility criteria, has an active chronic diagnosis, and is not currently enrolled in RPM or CCM. The result is a prioritized outreach list with estimated per-patient monthly revenue and projected program size.
How Many RPM-Eligible Patients Are in Your Panel?
Upload your patient roster and chronic disease diagnoses. Vizier identifies every RPM-eligible patient, models your maximum program revenue, and shows your current compliance gaps by patient and billing code.