CMS Clarifies 2021 PFS Reimbursements for Remote Patient Monitoring

In the final rule, to qualify for reimbursement under CPT codes 99457 and 99458, CMS mandated at least 20 minutes of interactive communication time between provider and patient over a calendar month, but that interactive communication couldn’t be part of the 20 minutes of RPM care. The agency has now clarified that “interactive communication” can include both in-person and connected health channels.

Both the Alliance for Connected Care – which drew attention to this week’s corrections – and the healthcare team at Foley & Lardner criticized the initial guidelines when they were released in a preliminary draft last August.

In addition, CMS added more context to a requirement that bases RPM reimbursement on a minimum of 16 days of data collected over a 30-day period and said RPM services associated with CPOT codes 99453 and 99454 could be billed once per provider per patient per 30-day period.