RPM in Medical Billing

Remote patient monitoring (RPM) services involve medical observation of patients outside clinical settings through dedicated technologies. As a result, they require different billing procedures compared to that patient monitoring for admitted patients. Integration of relevant billing solutions for remote patient monitoring services is vital for healthcare organizations to be able to provide remote care services. As the medical industry adopts digital technology at an increasing rate, remote patient monitoring is bound to become more commonplace, resulting in an increasing need for RPM billing integration. 

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Solutions For Remote Patient Monitoring Billing

Gathering patient data from RPM Monitoring devices and performing diagnoses is a medical service that falls under telemedicine. OSP can develop custom RPM billing modules as part of integrated healthcare solutions with features for charge capture to enable providers to bill for the services rendered to patients. It will allow doctors to document the medical services they perform with the help of remote patient monitoring technologies to prepare claims to be sent over to payers. The module to enable charge capture will make it possible for hospitals, clinics, and small, single-physician practices to incorporate telemedicine into their operations. 

The standardized ICD codes used for diagnoses performed during in-person clinical visits are not recognized for RPM billing. OSP can develop and incorporate the necessary functions in its RPM billing integration services and solutions. Furthermore, we can also carry out customizations to match the medical services provided by specific organizations. This will streamline preparing claims for RPM services at medical organizations. A simplified medical coding process for remote care services will go a long way in making up for the absence of home caregivers and optimizing the revenue cycles for providers offering these services.  

Claims for medical services rendered remotely may run into challenges as some payers view such services differently than those rendered for in-person clinical visits. In light of this, OSP can design, develop, and integrate a dedicated claims management module within the RPM billing platform. Providers use the same for medical services as the patients’ healthcare data is accumulated from RPM devices and stored in electronic health records. Our solutions will help to streamline the entire claims lifecycle for healthcare organizations. OSP’s solutions for streamlining claims management in the RPM medical billing process will help providers, payers, and patients.  

OSP will take the time to assess a healthcare organization’s services delivered through remote patient monitoring devices. Subsequently, we will design and program suitable application programming interfaces (APIs) to enable the organization to incorporate medical billing software within the RPM platform. We can also help integrate suitable remote patient monitoring solutions within an organization’s existing healthcare information management system or the billing system to include it in the revenue cycle management process. To sum it up, OSP can fast-track a clinic’s adoption of RCM services by helping implement the medical billing process. Our solutions will facilitate healthcare interoperability for seamless electronic data exchange among the platforms.  

OSP can provide solutions to facilitate RPM billing integration along with a module for denial management. Having spent a decade in the healthcare technology industry, we understand the problems caused by claim denials and the hassles of addressing them. OSP will analyze the requirements of an organization and include suitable denial management solutions as part of the RPM billing integration process. RPM billing is an integral part of telemedicine initiatives, and OSP will enable healthcare organizations to implement end-to-end revenue cycle management operations for the same in their workflows.   


OSP enables medical organizations to provide healthcare services remotely by developing customized APIs to integrate RPM billing solutions. Our services will help to eliminate any financial barriers for providers to offer remote patient monitoring and care services. As a result, provider organizations can effectively expand access to care for people who might not require in-person clinical visits. 

OSP’s solutions for RPM billing will ensure HIPAA compliance by securing patients’ medical and billing information. Our solutions will be tested thoroughly against established standards to prevent any data leakage or loss of integrity. Incorporating a billing solution into existing health systems and RPM platforms can also establish access controls and audit trails as additional layers of security.

When healthcare provider organizations can be certain of steady revenue cycles, they can provide reliable services to their patients. The incorporation of a system for remote patient monitoring billing goes on to serve all the stakeholders – the providers, payers, and the patients in the long run. Providers can focus their time and resources on caring for patients without worrying about revenue cycles.

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RPM Billing Software Development Services


Design and Development of Remote Patient Monitoring Software

  • Upload of patients’ vital signs from medical devices to EHR in real-time
  • Intuitive visualization tools to help providers interpret medical data better
  • Customized coding features to help bill for remote medical services
  • Compatible with processing data from medical devices and IoT-based wearables
  • Fast and simplified charge capture and claims generation for services

Development of Custom RPM Solutions According to Requirements

  • Development of remote patient monitoring billing solutions for telehealth platforms
  • RPM software with billing features for assisted living facilities
  • RPM billing integration solutions for clinics offering telehealth services
  • Development of custom telehealth platforms to support RPM billing claims
  • Implementation of RPM billing modules in existing health systems

Customized Remote Patient Monitoring Platforms With Streamlined Billing Features

  • User-friendly interface to improve usability
  • Streamlined charge capture for simplified billing
  • Claims generation and claims scrubbing for low denial rates
  • Inclusion of online payment options for patients
  • Patient portal module for patients to view their detailed bills

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Frequently Asked Questions

RPM (remote patient monitoring) is a subcategory of telehealth where providers can monitor patients’ health outside conventional clinical settings. This is accomplished using medical devices alongside digital and telecommunications technologies.   

When it comes to RPM billing, it involves providers billing for services they provide remotely for patients who avail of RPM and associated services. After doctors provide the RPM services, they are coded, and claims are generated. The out-of-pocket payments are collected from patients online, while the rest may be obtained as reimbursement from payers.  

  • Remote monitoring of vital signs, including weight, blood pressure, and pulse oximetry, along with the initial setup and patient training to use the equipment. This varies based on the frequency of the recordings taken and the duration of the devices used.   
  • Remote monitoring of patients along with interactive communication with a medical professional (usually over telehealth platforms). This is based on the frequency and duration of the communication with the providers.  

Remote patient monitoring services can be billed by any billing physician, qualified healthcare professional (QHCP), or clinical personnel under CPT Code 99457. This code requires at least 20 minutes of virtual medical services to the patient.  

CPT Code 99453: It is used for reporting the setting-up and education of patients on using the RPM devices. It is mostly used once per patient when the RPM services begin.  

CPT Code 99454: This code is used for reimbursement for the supply of remote monitoring devices and observation of patient data. The patient readings must be taken at least 16 days every month.  

CPT Code 99457: This code reports the time spent by a clinical professional in interactive communication with a patient for remote monitoring services. It needs at least 20 minutes logged for the code to be applicable.  

CPT Code 99458: This is an add-on code to 99457. It is used for an additional 20 minutes after the initial 20 minutes for the previous code. It can be billed in unlimited 20-minute increments each month.  

CPT Code 99091: Medical data is saved digitally and communicated by the patient or caregiver to a physician or other qualified healthcare professional (QHCP). It needs to be done for 30 minutes every 30 days. 

  • Data Security  

RPM, or remote patient monitoring, uses multiple devices to gather patient information. These are then relayed to the providers using varying technologies and data formats. So, it is important to ensure data security since the risk of data loss is increased because of the disparate nature of RPM services.  

  • Ensure Correct Billing  

Providers need to acquaint themselves with the reimbursement options in their practicing locations. This is because different payers would have different regulations or policies concerning RPM, and any oversight would cost providers their reimbursements.  

  • Regulatory Compliance  

Providers must ensure that all the devices used for remote patient monitoring comply with regulations. Since the regulations might evolve, it is important to ensure the companies building them follow compliant procedures.   

  • In-Person Visit  

When providers doubt a patient’s condition based on vital signs taken from RPM devices, it is best to bring them in for an in-person visit. Various factors might be missed during remote monitoring, and seeing a patient physically would help providers better understand the patient’s condition.  

The CMS guidelines for RPM medical billing require providers to have a minimum number of face-to-face interactions, report data periodically, and for the providers to be qualified medical professionals. Providers include the appropriate codes in their claims to indicate their services.   

HIPAA regulations require RPM services to ensure an adequate amount of data security, data privacy, and data integrity. Providers offering remote patient monitoring services must use medical devices from companies that employ compliant practices and ensure their devices comply with HIPAA. 

CPT Code: 99453 – For remote monitoring of physiologic parameters, including the initial setup and patient education on device use.  

CPT Code: 99454 – For monthly remote monitoring of physiologic parameters and the supply of the devices for patients.  

CPT Code: 99457 – For billing 20 minutes of interactive virtual care every month by a qualified healthcare professional.  

CPT Code: 99458 – This is used as an add-on with the 99547 for additional time blocks on top of the initial 20 minutes. 

Billing in remote patient monitoring involves providers using the appropriate CPT codes to file for reimbursements. It is for medical services provided as part of an RPM program.

  • Fewer on-call urgent doctor visits needed because of remote diagnoses  
  • Lower physician visits needed   
  • Beneficial for patients who can’t travel  
  • Lowered costs of care due to RPM  
  • Helps in increasing access to care for people living in distant locations  

A patient suffering from a chronic disease requires RPM services. He is prescribed a remote monitoring program that requires monitoring his blood pressure, heart rate, weight, and blood glucose levels. After sending his health vitals, the patient begins the program and communicates with his doctor.  

In this case, the provider can use the 99453 for the initial setup and 99454 for each month the patient transmits data. It has to happen for at least 16 days each month for the 99454 to be applicable. Moreover, if the patient requests virtual care, the provider can use the 99457 for 20 minutes of virtual interactive communication to offer medical services. 

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