RPM codes 99091 and 99457, generally used for telehealth and RPM, may be used to bill for Xpress ECG service. Chronic Care Management (CCM) Code 99490 can be billed concurrently with 99091 or 99457.
Code 99091 Description: Collection and interpretation of physiologic data (e.g., ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient and/or caregiver to the physician or other qualified health care professional, qualified by education, training, licensure/regulation (when applicable) requiring a minimum of 30 minutes of time.
Code 99091 can be billed no more than once in a 30-day period. The practitioner must obtain advance patient consent for the service and document this in the patient's medical record. A minimum of 30 minutes of the physician or other qualified healthcare professional time needs to be documented for data accession, review and interpretation, modification of care plan as necessary (including communication to patient and/or caregiver), and associated documentation.
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 99490 Description: Chronic care management services, at least 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month.
Code 99490 has the following required elements:
1. multiple (two or more) chronic conditions expected to last at least 12 months, or until the death of the patient;
2. chronic conditions place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline;
3. comprehensive care plan established, implemented, revised, or monitored.
To request an Xpress ECG Reimbursement Guide, please contact us!
Disclaimer: 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.