RPM codes 99457 and 99458, generally used for telehealth and RPM, may be used to bill for Xpress ECG service. Codes 93010 may also be billed for ECG interpretation.
Code 99457 Description: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff /physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.
Code 99457 can be billed no more than once in a calendar month. A minimum of 20 minutes clinical staff /physician/other qualified healthcare professional time needs to be documented. Code 99457 and 99091 cannot be billed concurrently by the same provider.
Code 99458 Description: Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring interactive communication with the patient/caregiver during the month; additional 20 minutes.
Code 93010 Description: Electrocardiogram, routine ECG with at least 12-leads; interpretation and report only.
For a typical Xpress ECG test, the physician office can bill 99457 when 20 minutes of time spent and an interactive communication (phone call or video call) with the patient are documented. For each additional 20 minutes spent in patient management and health education,99458 can be billed. Along with 93010, when all 3 codes (99457, 99458 and 93010) are used for Xpress ECG, the reimbursement can be $51-102 per test. QT Medical offers reimbursement assistance with an online platform that will facilitate your RPM billing preparation and enhance the success rate. For more information, please contact Customer Service: (855) 722-6006.
To request an Xpress ECG Reimbursement Guide, please contact us!
1. QT Medical has compiled this reimbursement information for your reference. This information is gathered from third party sources and is subject to change without notice. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. It is always the provider’s responsibility to determine medical necessity and submit appropriate codes, modifiers, and charges for services rendered. Please contact your local carrier/payer for interpretation of coding and coverage.
2. There are approximately 1,500 private payers in the United States, some very large and well-known, others smaller and regional. While private payers typically follow Medicare's reimbursements, each of their policies may vary. Therefore, it is important to check with the specific insurance's reimbursement policy.