Remote Patient Monitoring
POLICY
Remote patient monitoring (RPM) allows a patient to collect their own health data (for example, blood pressure) using a connected medical device that automatically transmits the data to their provider. The provider then uses this data to treat or manage the patient’s condition. RPM includes both remote physiological monitoring and remote therapeutic monitoring.
- Remote physiological monitoring involves using non-face-to-face technology to monitor and analyze a patient’s physiological metrics. Examples of physiological metrics include:
- Oxygen saturation
- Blood pressure
- Blood sugar or blood oxygen levels
- Weight loss or gain
- Remote therapeutic monitoring (RTM) captures non-physiological data, often self-reported, related to a therapeutic treatment. This includes data on a patient’s musculoskeletal or respiratory system. RTM can also monitor treatment adherence and treatment response. A connected medical device transmits the patient’s information.
RPM consists of 3 main components, each building off the step before it.
- Patient education & device setup: How to use the device; how to accurately collect data
- Device supply: Device examples; connecting the device so you can read results; how often patients should use devices
- Treatment management: Reviewing patient data to improve patient health outcomes
Although not considered to fall under the definition of telehealth, in 2018 CMS began making separate payment for the collection and interpretation of physiologic data. In 2019, they expanded their reimbursement to three remote physiologic monitoring codes, and an add-on code was added in 2020. Currently eligible codes include 99091, 99453, 99454, 99457, 99458. Each code has its own requirements in the code description.
SOURCE: CY 2019 Final Physician Fee Schedule. CMS, p. 123-125 & CY 2020 Final Physician Fee Schedule, CMS, p. 429, (Accessed Jul. 2025).
Remote therapeutic monitoring codes are similar to remote physiologic monitoring codes, however the primary billers are meant to be psychiatrists, nurse practitioners, and physical therapists, and allows non-physiological data to be collected. Codes include 98975, 98976, 98977, 98980, and 98981. Each code has its own requirements in the code description.
SOURCE: CY 2022 Physician Fee Schedule, CMS, p. 214-215, (Accessed Jul. 2025).
Home Health Agencies (HHAs) can provide more services to beneficiaries using telecommunications technology within the 30-day period of care, as long as it’s part of the patient’s plan of care and does not replace needed in-person visits as ordered on the plan of care. We acknowledge that the use of such technology may result in changes to the frequency or types of in-person visits outlined on existing or new plans of care. Telecommunications technology can include, for example: remote patient monitoring; telephone calls (audio only and TTY); and two-way audio-video technology that allows for real-time interaction between the clinician and patient. This provision is permanent beyond the COVID-19 PHE. Home health services furnished using telecommunication systems are required to be included on the home health claim beginning July 1, 2023.
The required face-to-face encounter for home health can be conducted via telehealth (i.e., 2-way audio-video telecommunications technology that allows for real-time interaction between the physician/allowed practitioner and the patient) when the patient is at home. After the PHE ends, the Consolidated Appropriations Act, 2023 provides for an extension for the flexibility to allow the home to be an originating site through December 31, 2024.
Note that chronic care management, principle care management, and transitional care management may also have remote monitoring applications.
SOURCE: CY 2019 Final Physician Fee Schedule. CMS, p. 126-128; CY 2020 Final Physician Fee Schedule. CMS, p. 390-421 & Medicare Learning Network Booklet, Chronic Care Management Services, May 2024 (Accessed Jul. 2025).
Practitioners may bill RPM or RTM, but not both, concurrently with the following services:
- Chronic Care Management (CCM)
- Transitional Care Management (TCM)
- Behavioral Health Integration (BHI)
- Principle Care Management (PCM)
- Chronic Pain Management (CPM)
RTM and RPM cannot be billed together.
FQHCs/RHCs
- Behavioral Health Integration: BHI is a team-based, collaborative approach to care that focuses on integrative treatment of patients with primary care and mental or behavioral health conditions. Effective January 1, 2018, RHCs and FQHCs are paid for general BHI services when a minimum of 20 minutes of qualifying general BHI services during a calendar month is furnished to patients with one or more new or pre-existing behavioral health or psychiatric conditions being treated by the RHC or FQHC primary care practitioner, including substance use disorders, that, in the clinical judgment of the RHC or FQHC primary care practitioner, warrants BHI services. General BHI service requirements include:
- An initial assessment and ongoing monitoring using validated clinical rating scales;
- Behavioral health care planning in relation to behavioral/psychiatric health problems, including revision for patients who are not progressing or whose status changes;
- Facilitating and coordinating treatment such as psychotherapy, pharmacotherapy, counseling and/or psychiatric consultation; and
- Continuity of care with a designated member of the care team.
- RPM Services: Effective January 1, 2024, RHCs and FQHCs are paid for RPM services when a minimum of 20 minutes of qualifying non-face-to-face RPM services are furnished during a calendar month. RPM services include the collection, analysis, and interpretation of digitally collected physiologic data, followed by the development of a treatment plan, and the managing of a patient under the treatment plan. RHCs and FQHCs are also paid for the initial set-up and patient education on use of the equipment that stores the physiologic data for RPM services.
- RTM Services: Effective January 1, 2024, RHCs and FQHCs are paid for RTM services when a minimum of 20 minutes of qualifying non-face-to-face RTM services are furnished during a calendar month. RTM services include remote monitoring of respiratory system status, musculoskeletal status, therapy adherence, or therapy response. RHCs and FQHCs are also paid for the initial set-up and patient education on use of the equipment that stores the physiologic data for RTM services.
- CHI Services: Effective January 1, 2024, RHCs and FQHCs are paid for CHI services when a minimum of 60 minutes of qualifying non-face-to-face CHI services are furnished during a calendar month. CHI services include coordination of care, facilitation of access to services, and communication between settings to address the SDOH need(s) that may interfere with, or present a barrier to, the diagnosis or treatment of a patient.
- PIN-Peer Support Services: Effective January 1, 2024, RHCs and FQHCs are paid for PIN services when a minimum of 60 minutes of qualifying non-face-to-face PIN services are furnished during a calendar month. PIN services include health care navigation as part of the treatment plan for a serious, high-risk disease expected to last at least 3 months, that places the patient at significant risk of hospitalization or nursing home placement, acute exacerbation/decompensation, functional decline, or death.
- PIN-Peer Support (PIN-PS) Services: Effective January 1, 2024, RHCs and FQHCs are paid for PIN-PS services when a minimum of 60 minutes of qualifying PIN-PS services are furnished during a calendar month. PIN-PS services include the treatment of high-risk behavioral health conditions.
- Advanced Primary Care Management Services: Advanced Primary Care Management services combine elements of several existing care management and communication technology-based services that include essential elements such as Chronic Care Management (CCM), Transitional Care Management (TCM), and Principal Care Management (PCM). RHCs and FQHCs can bill for APCM services once per patient per calendar month using an APCM HCPCS code when the billing requirements are met. APCM services aren’t time based.
Care Coordination Services (CCM): CCM services furnished between January 1, 2016, and December 31, 2017, are paid based on the PFS national average non-facility payment rate when CPT code 99490 is billed alone or with other payable services on an RHC or FQHC claim.
See manual for additional details on care coordination.
Mental Health
Digital mental health treatment (DMHT) devices provided “incident to” professional behavioral health services used along with ongoing treatment under a behavioral health treatment plan or therapy plan of care.
- The billing practitioner must prescribe or order the DMHT device that’s been cleared under section 510(k) of the Food, Drug, and Cosmetics Act
- The patient can use the DMHT device at home or in an outpatient setting, if that’s how FDA classified the device for use under 21 CFR 882.5801
CONDITIONS
Remote physiologic monitoring:
- You must monitor an acute or chronic condition
- You must collect data for at least 16 days out of 30 days (doesn’t apply to treatment management codes 99457, 99458, 98980, and 98981)
Monitoring must be medically reasonable and necessary
Note that specific condition requirements apply for chronic care management, principle care management, and transitional care management which may also have remote monitoring applications.
SOURCE: CY 2019 Final Physician Fee Schedule. CMS, p. 123-125; CY 2020 Final Physician Fee Schedule, CMS, p. 429 & Medicare Learning Network Booklet, Chronic Care Management Services, May 2024, (Accessed Jul. 2025).
Cardiovascular System
The CPT codes 93731, 93734, 93741 and 93743 are used to report electronic analyses of single or dual chamber pacemakers and single or dual chamber implantable cardioverterdefibrillators. In the office, a physician uses a device called a programmer to obtain information about the status and performance of the device and to evaluate the patient’s cardiac rhythm and response to the implanted device.
Advances in information technology now enable physicians to evaluate patients with implanted cardiac devices without requiring the patient to be present in the physician’s office. Using a manufacturer’s specific monitor/transmitter, a patient can send complete device data and specific cardiac data to a distant receiving station or secure Internet server. The electronic analysis of cardiac device data that is remotely obtained provides immediate and long-term data on the device and clinical data on the patient’s cardiac functioning equivalent to that obtained during an in-office evaluation. Physicians should report the electronic analysis of an implanted cardiac device using remotely obtained data as described above with CPT code 93731, 93734, 93741 or 93743, depending on the type of cardiac device implanted in the patient.
SOURCE: Center for Medicare and Medicaid Services, Medicare Claims Processing Manual, Chapter 12 – Physicians/Nonphysicians Practitioners (12/19/24), p. 31-32. (Accessed Jul. 2025).
PROVIDER LIMITATIONS
Only physicians and non-physician practitioners eligible to provide evaluation and management services can bill RPM services
Only one practitioner can bill for RPM per patient in a 30-day period
You may bill remote physiologic monitoring and RTM, but not both, concurrently with the following care management services for the same patient if you don’t count time and effort twice: chronic care management, transitional care management, behavioral health integration, principal care management, and chronic pain management
Practitioners who aren’t receiving the global periods of surgery service payment can bill for RPM services
We require patient consent at the time you provide RPM services
You must electronically collect physiologic data and automatically upload it to a secure location where the data can be available for analysis and interpretation by the billing practitioner
The device used to collect and transmit the data must meet the definition of a medical device defined by the FDA
Auxiliary personnel can provide RPM services under the general supervision of the billing practitioner
For remote physiologic monitoring, we note that the term, ‘‘other qualified healthcare professionals,’’ used in the code descriptor is defined by CPT, and that definition can be found in the CPT Codebook.
SOURCE: CY 2019 Final Physician Fee Schedule. CMS, p. 123-125, (Accessed Jul. 2025).
CMS has designated RPM codes 99457 and 99458 as defined in Sec. 410.26(b)(5). See below for referenced definition:
In general, services and supplies must be furnished under the direct supervision of the physician (or other practitioner). Designated care management services can be furnished under general supervision of the physician (or other practitioner) when these services or supplies are provided incident to the services of a physician (or other practitioner). Behavioral health services can be furnished under general supervision of the physician (or other practitioner) when these services or supplies are provided by auxiliary personnel incident to the services of a physician (or other practitioner). The physician (or other practitioner) supervising the auxiliary personnel need not be the same physician (or other practitioner) who is treating the patient more broadly. However, only the supervising physician (or other practitioner) may bill Medicare for incident to services.
SOURCE: CY 2020 Final Physician Fee Schedule. CMS, p. 431 & 42 CFR 410.26, (Accessed Jul. 2025).
See Chronic Care Management Services Booklet for instructions regarding concurrent billing of CCM, TCM and RTM codes.
Home Health Agencies
An individualized plan of care must be established and periodically reviewed by the certifying physician or allowed practitioner. The plan of care must include all of the following: … Any provision of remote patient monitoring or other services furnished via telecommunications technology (as defined in § 409.46(e)) or audio-only technology. Such services must be tied to the patient-specific needs as identified in the comprehensive assessment, cannot substitute for a home visit ordered as part of the plan of care, and cannot be considered a home visit for the purposes of patient eligibility or payment.
Telecommunications technology, as indicated on the plan of care, can include: remote patient monitoring, defined as the collection of physiologic data (for example, ECG, blood pressure, glucose monitoring) digitally stored and/or transmitted by the patient or caregiver or both to the home health agency; teletypewriter (TTY); and 2-way audio-video telecommunications technology that allows for real-time interaction between the patient and clinician. The costs of any equipment, set-up, and service related to the technology are allowable only as administrative costs. Visits to a beneficiary’s home for the sole purpose of supplying, connecting, or training the patient on the technology, without the provision of a skilled service, are not separately billable.
SOURCE: 42 CFR Sec. 409.43 & 409.46, (Accessed Jul. 2025).
Starting on or after January 1, 2023, they may voluntarily report the use of telecommunications technology in providing HH services on HH payment claims. CMS will require this information on HH claims starting on July 1, 2023. Home Health Agencies will submit the use of telecommunications technology on the HH claim using the following 3 G-codes:
- G0320: Home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system
- G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
- G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (for example, remote patient monitoring)
As of July 1, 2023, you must report the use of telehealth technology in providing home health (HH) services on HH payment claims. See MLN Matters article MM12805 for more information.
You must submit the use of telecommunications technology on the HH claims using the following 3 HCPCS codes:
- G0320: Home health services furnished using synchronous telemedicine rendered via real-time two-way audio and video telecommunications system
- G0321: Home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
- G0322: The collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring)
See fact sheet for additional details.
Beginning on or after January 1, 2023, HHAs may voluntarily report the use of telecommunications technology in the provision of home health services on claims. This information is required on home health claims beginning on July 1, 2023. HHAs shall submit the use of telecommunications technology when furnishing home health services, on the home health claim via three G-codes.
- G0320: home health services furnished using synchronous telemedicine rendered via a real-time two-way audio and video telecommunications system
- G0321: home health services furnished using synchronous telemedicine rendered via telephone or other real-time interactive audio-only telecommunications system
- G0322: the collection of physiologic data digitally stored and/or transmitted by the patient to the home health agency (i.e., remote patient monitoring).
HHAs shall submit services furnished via telecommunications technology in line item detail and each service must be reported as a separately dated line under the appropriate revenue code for each discipline furnishing the service. Two occurrences of G0320 or G0321 on the same day for the same revenue code shall be reported as separate line items with the same date of service and with service units reporting 1.
The use of remote patient monitoring that spans a number of days shall be reported as a single G0322 line item reporting the beginning date of monitoring and the number of days of monitoring in the units field. If more than one discipline is using the remote monitoring information during the billing period, the HHA may choose which revenue code to report on the remote monitoring line item.
Claims with no billable visits are not submitted to Medicare, including claims for billing periods where only telehealth services are provided.
CMS will include the CPT codes related to RPM and RTM in the general care management code HCPCS G0511 which will provide FQHCs/RHCs payment for RTM and RPM services. CMS noted that these services are similar to the nonface-to-face requirements for general care management services and reflect the additional resources needed to provide such services by an FQHC/RHC.
OTHER RESTRICTIONS
Remote physiologic monitoring, but not RTM, requires an established patient relationship
You can’t bill remote physiologic monitoring and RTM together
Although multiple devices can be provided to a patient, the services associated with all of the medical devices “can be billed only once per patient per 30-day period and only when at least 16 days of data have been collected.” This applies even when multiple devices are used.
Regarding global payment and how RTM and RPM maybe used, CMS notes that when a beneficiary’s procedure/surgery and related services are covered by a global payment, RPM or RTM services may be furnished separately and the provider will be paid for them separately from the global payment. If the beneficiary is currently receiving services during a global period, the provider may also furnish RPM or RTM services and the provider will receive a separate payment if the RPM/RTM services are unrelated to the diagnosis for the global procedure and are separate and distinct from the global procedure. See the 2024 Final Rule for more details
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