TELEHEALTH CLINICAL SOLUTIONS
Remote Patient Monitoring (RPM)
Remote patient monitoring (RPM) is a healthcare delivery method that uses digital technology to monitor patients outside traditional clinical settings, such as at home. RPM involves the use of connected medical devices-like blood pressure monitors, blood glucose meters, pulse oximeters, weight scales, and wearable sensors-to collect a wide range of physiological and health data from patients. This data is then electronically transmitted to healthcare providers for ongoing assessment and management.
2025 Remote Patient Monitoring (CPT) Codes
| 99453 | Initial set-up & patient education on equipment (one-time fee). | $22.25 |
| 99454 | Supply of devices, Data collection and transmission, 16 days per month. | $43.02 |
| 99457 | Remote physiologic monitoring services by clinical staff/MD/ QHCP first 20 cumulative minutes of RPM services over a 30-day period. | $47.87 |
| 99458 | Remote physiologic monitoring services by clinical staff/MD/ QHCP for an additional cumulative 20 minutes of RPM services over a 30-day period. | $38.49 |
| 99091 | Collection and interpretation of data by physician or QHCP, 30 minutes. | $54.22 |
Chronic Care Management (CCM)
Chronic Care Management (CCM) is a structured healthcare service designed to support individuals with two or more chronic health conditions that are expected to last at least 12 months or until the patient’s death, or that place the patient at significant risk of death, acute exacerbation, or functional decline. CCM is covered by Medicare and most private insurance providers.
2025 Chronic Care Management (CPT) Codes
| 99490 | Minimum 20 cumulative minutes over a 30-day period of non-face-to-face time monitoring the care plan. | $60.49 |
| 99439 | Subsequent 20 minutes of care provided by clinical staff. | $45.93 |
| 99491 | Initial 30 minutes of care personally provided by physician, or non-physician practitioner (NPP). | $91.45 |
| 99437 | Subsequent 30 minutes of care personally provided by a physician or NPP. | $64.36 |
Transitional Care Management (TCM)
Transitional Care Management (TCM) services are a set of structured medical and care-coordination activities that support a patient’s safe transition from an inpatient or facility setting (such as a hospital or skilled nursing facility) back to their home, assisted living facility, or other community setting, usually over a 30‑day period after discharge without a gap in services. TCM is designed for patients whose medical and/or psychosocial problems require moderate or high complexity medical decision making during this transition period. The main goals are to reduce complications and readmissions, improve continuity of care, and help the patient successfully reintegrate into home or community living.
2025 Transitional Care Management (TCM) Codes
| CPT code | Description (complexity & timing) | Estimated 2025 National Avg Reimbursement |
|---|---|---|
| 99495 | Moderate complexity, visit ≤14 days post-discharge | $201-$202 per claim |
| 99496 | High complexity, visit ≤7 days post-discharge | $273 per claim |
Remote Therapeutic Monitoring (RTM)
Remote Therapeutic Management (RTM) is a healthcare service that uses digital technology to remotely monitor and manage a patient’s therapy, particularly for chronic conditions affecting the musculoskeletal or respiratory systems. The primary focus of RTM is on collecting and assessing non-physiological patient data-such as symptoms, therapy adherence, medication response, and self-reported outcomes-rather than physiological metrics like blood pressure or glucose levels.
2025 Remote Therapeutic Monitoring (RTM) Codes
| 98975 | Remote therapeutic monitoring (e.g., respiratory system status, musculoskeletal system status, therapy adherence, therapy response); initial set-up and patient education on use of equipment | $19.73 |
| 98976 | RTM (respiratory); supply 16 readings per month. See “98977” | $49.04 |
| 98977 | RTM (musculoskeletal); device(s) supply with scheduled (e.g., daily) recording(s), manual reporting by patient, and/or programmed alert(s) transmission to monitor musculoskeletal system, each 30 days [16 readings minimum each 30 days] | $43.02 |
| 98980 | At least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, requiring at least one interactive communication with the patient/caregiver during the calendar month | $52.23 |
| 98981 | Each additional 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month (list separately in addition to code for primary procedure) | $39.14 |
Principal Care Management (PCM)
Remote Therapeutic Management (RTM) is a healthcare service that uses digital technology to remotely monitor and manage a patient’s therapy, particularly for chronic conditions affecting the musculoskeletal or respiratory systems. The primary focus of RTM is on collecting and assessing non-physiological patient data-such as symptoms, therapy adherence, medication response, and self-reported outcomes-rather than physiological metrics like blood pressure or glucose levels.
2025 Principal Care Management (PCM) Codes
| CPT code | Description | Approx. 2025 Medicare National Average Reimbursement* |
|---|---|---|
| 99424 | First 30 minutes of PCM per calendar month, provided personally by physician or other qualified health care professional | $81-$83 |
| 99425 | Each additional 30 minutes of PCM per month by physician/QHP (add-on to 99424) | $55-$60 |
| 99426 | First 30 minutes of PCM per month by clinical staff under general supervision of physician/QHP | $60-$70 |
| 99427 | Each additional 30 minutes of clinical staff PCM per month (add-on to 99426) | $48-$60 |
